1.
History of psychiatric institutions
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The rise of the lunatic asylum and its gradual transformation into, and eventual replacement by, the modern psychiatric hospital, explains the rise of organized, institutional psychiatry. This growth coincided with the development of alienism, now known as psychiatry, in the Islamic world, the Bimaristans were described by European travelers, who wrote about their wonder at the care and kindness shown to lunatics. In 872, Ahmad ibn Tulun built a hospital in Cairo that provided care to the insane, in Europe during the medieval era, the small subsection of the population of the mad who were housed in institutional settings were held in a variety of settings. Porter gives examples of such locales where some of the insane were cared for, a few towns had towers where madmen were kept. Dave Sheppards Development of Mental Health Law and Practice begins in 1285 with a case that linked the instigation of the devil with being frantic and mad. In Spain, other institutions for the insane were established after the Christian Reconquista, facilities included hospitals in Valencia, Zaragoza, Seville, Barcelona. In London, England, The Priory of Saint Mary of Bethlehem, at the start of the fifteenth century, it housed six insane men. The level of specialist institutional provision for the care and control of the insane remained extremely limited at the turn of the 18th century, madness was seen principally as a domestic problem, with families and parish authorities in Europe and England central to regimens of care. In the late 17th century, this began to change. Inmates who were deemed dangerous or disturbing were chained, but Bethlem was an open building. Its inhabitants could roam around its confines and possibly throughout the neighborhood in which the hospital was situated. In 1676, Bethlem expanded into newly built premises at Moorfields with a capacity for 100 inmates, A second public institution was opened in 1713. It was a facility which generally housed between twenty and thirty inmates. In 1728 at Guys Hospital, London, wards were established for chronic lunatics, a similar expansion took place in the British American colonies. The Pennsylvania Hospital was founded in Philadelphia in 1751 as a result of work begun in 1709 by the Religious Society of Friends, a portion of this hospital was set apart for the mentally ill, and the first patients were admitted in 1752. Virginia is recognized as the first state to establish an institution for the mentally ill, references to such institutions are limited for the seventeenth-century but it is evident that by the start of the eighteenth-century, the so-called trade in lunacy was well established. Daniel Defoe, an ardent critic of private madhouses, estimated in 1724 that there were fifteen then operating in the London area, Defoe may have exaggerated but exact figures for private metropolitan madhouses are available only from 1774, when licensing legislation was introduced, sixteen institutions were recorded. At least two of these, Hoxton House and Woods Close, Clerkenwell, had been in operation since the seventeenth century, by 1807, the number had increased to seventeen
2.
Traverse City State Hospital
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The Traverse City State Hospital of Traverse City, Michigan has been variously known as the Northern Michigan Asylum and the Traverse City Regional Psychiatric Hospital. It is the last Kirkbride Building of Michigans original four left in the state and it was listed on the National Register of Historic Places in 1978 and designated a Michigan State Historic Site in 1985. Northern Michigan Asylum was established in 1881 as the demand for a psychiatric hospital, in addition to those established in Kalamazoo and Pontiac. Lumber baron Perry Hannah, the father of Traverse City, used his influence to secure its location in his home town. Under the supervision of prominent architect Gordon W. Lloyd, the first building, the hospital opened in 1885 with 43 residents. Under Dr. James Decker Munson, the first superintendent from 1885 to 1924, twelve housing cottages and two infirmaries were built between 1887 and 1903 to meet the specific needs of male and female patients. The institution became the citys largest employer and contributed to its growth, in the 1930s three large college-like buildings were constructed near the present site of the Munson Hospital parking deck and the Grand Traverse Pavilions. Long before the advent of drug therapy in the 1950s, Munson was a believer in the beauty is therapy philosophy. Patients were treated through kindness, comfort, pleasure, and beautiful flowers provided year-round by the asylums own greenhouses, restraints, such as the straitjacket, were forbidden. The asylum farm began in 1885 with the purchase of some milk cows and within a decade grew to include pigs, chickens, milk and meat cows, in the 1910s-30s, the farm was home to a world champion milk cow, Traverse Colantha Walker. Her grave is at the end of the trail between the farm and the asylum. While the hospital was established for the care of the ill, its use expanded during outbreaks of tuberculosis, typhoid, diphtheria, influenza. It also cared for the elderly, served as a rehab for drug addicts, after Munsons retirement, James Decker Munson Hospital was established in his honor on the grounds in 1926, and was operated by the state well after his death and into the 1950s. It was then replaced by Munson Medical Center in the 1950s, a portrait of Dr. Munson hangs inside the main lobby of Munson Medical Center. By the time it closed in 1989, pieces of the property had been split between Munson hospital, the Pavilions, Garfield Township and T. M. G, however, changes in the law and mental health care philosophies brought on the decline of the institution. The farm on the closed in the 1950s, with most of its buildings demolished in the mid-1970s. In 1963, the main 1885 center wing of Building 50 was destroyed because it was deemed a fire hazard, use of the hospital slowly declined, and it was closed in 1989, with a loss of over 200 jobs to the local economy. Over the next decade, the community struggled with plans for reuse of the hospital grounds, in 1993, the property was transferred from the state to the Grand Traverse Commons Redevelopment Corporation
3.
Traverse City, Michigan
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Traverse City is a city in the U. S. state of Michigan. It is the county seat of Grand Traverse County, although a portion extends into Leelanau County. It is the largest city in the 21-county Northern Michigan region, the population was 14,674 at the 2010 census, with 143,372 in the Traverse City micropolitan area. The Traverse City area is the largest producer of cherries in the United States. Near the time of cherry harvest, the city hosts the annual week-long National Cherry Festival in the first full week of July, the surrounding countryside also produces grapes, and is one of the centers of wine production in the Midwest. Tourism, both summer and winter, is another key industry, the Traverse City area features varied natural attractions, including freshwater beaches, vineyards, a National Lakeshore, downhill skiing areas, and numerous forests. In 2009, TripAdvisor named Traverse City the number two small town travel destination in the United States, in 2012, the city was listed among the 10 best places to retire in the U. S. by U. S. News. Traverse City is named after the Grand Traverse Bay, which the city heads, the bay earned its name from 18th-century French voyageurs who made la grande traverse, or the long crossing, across the mouth of bay. On Old Mission peninsula, Rev Peter Doughtery started the first permanent settlement in 1839, in 1847, Captain Boardman of Naperville, Illinois, purchased the land at the mouth of the Boardman River at the head of the west arm of the bay. During that year the captain, his son, and their employees built a dwelling, in 1851 the Boardmans sold the sawmill to Hannah, Lay & Co, who improved the mill greatly. The increased investment in the mill attracted settlers to the new community. As of 1853, the operating post office in the Grand Traverse Bay region was the one located at Old Mission. While in Washington, D. C. in 1852, Mr. Lay had succeeded in getting the U. S, post Office to authorize a new post office at his newer settlement. Mr. Lay agreed to the name Traverse City for the post office, in December 1872, rail service arrived in Traverse City via a Traverse City Rail Road Company spur from the Grand Rapids and Indiana Railroad line at Walton Junction. This opened up the area to settlement and industrial development, as a result, they have viticulture and Cherry orchards. Consequently, it generally experiences warm, mild summers and severe winters, lake-effect snowfall constitutes a large percentage of the total annual snow accumulation, which averages around 80 inches. Periods of snowfall typically last from November to April, although light snow as late as May or as early as late September sometimes occur. Traverse Citys record high temperature is 105 °F, recorded in 1936, Traverse City is a part of the greater Northern Michigan region
4.
Hospital
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A hospital is a health care institution providing patient treatment with specialized medical and nursing staff and medical equipment. The best-known type of hospital is the hospital, which typically has an emergency department to treat urgent health problems ranging from fire. A district hospital typically is the health care facility in its region, with large numbers of beds for intensive care. Specialised hospitals can help reduce health care costs compared to general hospitals, a teaching hospital combines assistance to people with teaching to medical students and nurses. The medical facility smaller than a hospital is called a clinic. Hospitals have a range of departments and specialist units such as cardiology, some hospitals have outpatient departments and some have chronic treatment units. Common support units include a pharmacy, pathology, and radiology, Hospitals are usually funded by the public sector, by health organisations, by health insurance companies, or by charities, including direct charitable donations. Historically, hospitals were founded and funded by religious orders, or by charitable individuals. During the Middle Ages, hospitals served different functions from modern institutions, Middle Ages hospitals were almshouses for the poor, hostels for pilgrims, or hospital schools. The word hospital comes from the Latin hospes, signifying a stranger or foreigner, another noun derived from this, hospitium came to signify hospitality, that is the relation between guest and shelterer, hospitality, friendliness, and hospitable reception. By metonymy the Latin word then came to mean a guest-chamber, guests lodging, hospes is thus the root for the English words host hospitality, hospice, hostel and hotel. The German word Spital shares similar roots, the grammar of the word differs slightly depending on the dialect. Some patients go to a hospital just for diagnosis, treatment, or therapy and then leave without staying overnight, while others are admitted and stay overnight or for several days or weeks or months. Hospitals usually are distinguished from other types of facilities by their ability to admit and care for inpatients whilst the others. Larger cities may have several hospitals of varying sizes and facilities, some hospitals, especially in the United States and Canada, have their own ambulance service. A district hospital typically is the health care facility in its region, with large numbers of beds for intensive care. In California, district hospital refers specifically to a class of healthcare facility created shortly after World War II to address a shortage of beds in many local communities. Twenty-eight of Californias rural hospitals and 20 of its critical-access hospitals are District hospitals, Californias District hospitals are formed by local municipalities, have Boards that are individually elected by their local communities, and exist to serve local needs
5.
Psychiatric medication
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A psychiatric medication is a licensed psychoactive drug taken to exert an effect on the chemical makeup of the brain and nervous system. Thus, these medications are used to treat mental illnesses, usually prescribed in psychiatric settings, these medications are typically made of synthetic chemical compounds. The recidivism or rehospitalization of the mentally ill is at a rate in many countries. Modern psychiatric medication has advanced greatly in the past century, the reuptake hypothesis by Julius Axelrod involves the interaction among neurotransmitters, and forms the cornerstone of the development of modern psychotropic drugs. His work allowed researchers to advance their studies into the effects of psychiatric medication. Mental health medications were first introduced in the century with the widespread introduction of chlorpromazine. The popularity of these drugs have skyrocketed since then, with millions prescribed annually, psychiatric medications are prescription medications, requiring a prescription from a physician, such as a psychiatrist, or a psychiatric nurse practitioner, PMHNP, before they can be obtained. In addition to the dosage in pill form, psychiatric medications are evolving into more novel methods of drug delivery. New technologies include transdermal, transmucosal, inhalation, and suppository supplements, psychopharmacology studies a wide range of substances with various types of psychoactive properties. While studies are conducted on all psychoactive drugs by both fields, psychopharmacology focuses on psychoactive and chemical interactions within the brain, physicians who research psychiatric medications are psychopharmacologists, specialists in the field of psychopharmacology. Psychiatric medications carry risk for adverse effects, the occurrence of adverse effects can potentially reduce drug compliance. Some adverse effects can be treated symptomatically by using adjunct medications such as anticholinergics, there are six main groups of psychiatric medications. Antidepressants, which treat disorders such as clinical depression, dysthymia, anxiety disorders, eating disorders. Antipsychotics, which treat disorders such as schizophrenia and psychotic symptoms occurring in the context of other disorders such as mood disorders. Depressants, which are used as hypnotics, sedatives, and anesthetics, mood stabilizers, which treat bipolar disorder and schizoaffective disorder. Stimulants, which treat disorders such as attention deficit hyperactivity disorder, antidepressants are drugs used to treat clinical depression, and they are also often used for anxiety and other disorders. Most antidepressants will hinder the breakdown of serotonin or norepinephrine or both, a commonly used class of antidepressants are called selective serotonin reuptake inhibitors, which act on serotonin transporters in the brain to increase levels of serotonin in the synaptic cleft. SSRIs will often take 3–5 weeks to have a noticeable effect, there are multiple classes of antidepressants which have different mechanisms of action
6.
Psychotherapy
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Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction, to help a person change and overcome problems in desired ways. Certain psychotherapies are considered evidence-based for treating some diagnosed mental disorders, there are over a thousand different psychotherapy techniques, some being minor variations, while others are based on very different conceptions of psychology, ethics or techniques. Most involve one-to-one sessions, between client and therapist, but some are conducted with groups, including families, the term psychotherapy is derived from Ancient Greek psyche and therapeia. The Oxford English Dictionary defines it now as The treatment of disorders of the mind or personality by psychological methods, the American Psychological Association adopted a resolution on the effectiveness of psychotherapy in 2012 based on a definition developed by John C. Some definitions of counseling overlap with psychotherapy, or counseling may refer to guidance for everyday problems in specific areas, somatotherapy refers to the use of physical methods as treatments, and sociotherapy to the use of a persons social environment to effect therapeutic change. Historically psychotherapy has sometimes meant interpretative methods, namely psychoanalysis, in contrast with other methods to treat disorders such as behavior modification. Psychotherapy is often dubbed talking therapy, particularly for a general audience, children or adults who do not engage in verbal communication are not excluded from psychotherapy, indeed some types are designed for such cases. Psychotherapists may be mental health professionals, professionals from other backgrounds trained in a specific therapy, psychiatrists are first trained as physicians. As such, they may prescribe prescription medication, specialist psychiatric training begins after medical school in psychiatric residencies. Clinical psychologists have specialist doctoral degrees in psychology with clinical and research components, clinical social workers, mental health and intellectual disability nurses may have specialized training and practical experience in psychotherapy. Many of the variety of training programs and institutional settings are multi-professional. In most countries professionals doing specialized psychotherapeutic work also require a program of continuing education after the basic degree, as sensitive and deeply personal topics are often discussed during psychotherapy, therapists are expected, and usually legally bound, to respect client or patient confidentiality. As of 2015 there is much variation between European countries. A few have no regulation of the practice or no protection of the title, which titles are protected also varies. The European Association for Psychotherapy set up after the 1990 Strasbourg Declaration on Psychotherapy attempts to set independent pan-European standards, Social workers may complete the specialist training for child and teenage clients. Similarly in Italy, the practice of psychotherapy is restricted to graduates in psychology or medicine who have completed four years of recognised specialist training, austria and Switzerland have laws that recognize multidifunctional-disciplinary approaches. In the United Kingdom, psychotherapy is voluntarily regulated, there are many smaller professional bodies and associations such as the Association of Child Psychotherapists and the British Psychotherapy Foundation. Licensing and regulation are performed by the various states, presentation of practice as licensed, but without such a license, is generally illegal
7.
Physical restraint
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Physical restraint refers to means of purposely limiting or obstructing the freedom of a persons bodily movement. Usually, binding objects such as handcuffs, legcuffs, ropes, chains and this less commonly also extends to joint locks and pinning techniques. The freedom of movement in terms of locomotion is usually limited, by locking a person into a space, such as a prison cell. This effect can also be achieved by seizing and withholding specific items of clothing, examples can be protective clothing against temperature, hereby factually constraining the individual to remain in a sheltered spot. This also refers to taking away a persons shoes in a situation of captivity, the freedom of movement is practically restricted in many everyday situations without the protection offered by conventional footwear. Various ground textures in urban as well as natural areas can cause substantial physical distress for a shoeless person, ground textures consisting of crushed stone or similar construction aggregate can be practically impossible for a person to walk or run over without wearing shoes. Aside from extreme circumstances, a person is steadily compromised by the usual imponderabilities of most surroundings. Controlling the free movement of detainees by keeping them barefoot is common practice in many countries. A main motive can be seen in the fact, that the effects of frustrating prison escape and curbing acts of resistance are obtained without cost. Further it is an effective complementation of binding restraints, british Police officers are authorised to use leg and arm restraints, if they have been instructed in their use. Pouches carrying restraints are usually carried on the duty belt, for restraint for medical or psychiatric purposes, see medical restraint. Individuals with Disabilities Education Act has stated that Restraints may not be used as an alternative to adequate staff, also, restraint may be used only when aggressive behavior interferes with an individuals own ability to benefit from programming or poses physical threat to others. The misuse of physical restraint has resulted in many deaths, physical restraint can be dangerous, sometimes in unexpected ways. Gagging a restrained person is highly risky, as it involves a risk of asphyxia. Gags that prevent communication may also prevent the communication of distress that might otherwise prevent injury, a survey in the US in 1998 reported an estimated 150 restraint related deaths in care environments. Low frequency fatalities occur with some degree of regularity, an investigated of 45 restraint related deaths in US childcare settings showed 28 of these deaths were reported to have occurred in the prone position. In the UK restraint related deaths would appear to be reported less often, the evidence for effective staff training in the use of medical restraints is at best crude, with evaluation of training programmes being the exception rather than the rule. Vast numbers of staff are trained in ‘physical interventions’ including physical restraint
8.
Emergency department
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The emergency department is usually found in a hospital or other primary care center. In some countries, emergency departments have become important entry points for those without means of access to medical care. The emergency departments of most hospitals operate 24 hours a day, griswold also equipped police and fire vehicles with medical supplies and trained officers to give emergency care while en route to the hospital. Today, a hospital has its emergency department in its own section of the ground floor of the grounds. As patients can present at any time and with any complaint, triage is normally the first stage the patient passes through, and consists of a brief assessment, including a set of vital signs, and the assignment of a chief complaint. Most emergency departments have an area for this process to take place. Most patients will be assessed at triage and then passed to another area of the department, or another area of the hospital. Conversely, patients with serious conditions, such as cardiac arrest, will bypass triage altogether. The resuscitation area, commonly referred to as Trauma or Resus, is a key area in most departments, the most seriously ill or injured patients will be dealt with in this area, as it contains the equipment and staff required for dealing with immediately life-threatening illnesses and injuries. Typical resuscitation staffing involves at least one attending physician, and at least one and these personnel may be assigned to the resuscitation area for the entirety of the shift, or may be on call for resuscitation coverage. Examples of majors include chest pain, difficulty breathing, abdominal pain, Advanced diagnostic testing may be conducted at this stage, including laboratory testing of blood and/or urine, ultrasonography, CT or MRI scanning. Medications appropriate to manage the condition will also be given. Depending on underlying causes of the chief complaint, he or she may be discharged home from this area or admitted to the hospital for further treatment. Patients whose condition is not immediately life-threatening will be sent to an area suitable to deal with them, such patients may still have been found to have significant problems, including fractures, dislocations, and lacerations requiring suturing. Children can present particular challenges in treatment, many hospitals have a separate area for evaluation of psychiatric problems. These are often staffed by psychiatrists and mental health nurses and social workers, there is typically at least one room for people who are actively a risk to themselves or others. Fast decisions on life-and-death cases are critical in emergency rooms. As a result, doctors face great pressures to overtest and overtreat, other common variations include emergency ward, emergency centre or emergency unit
9.
United Kingdom
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The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom or Britain, is a sovereign country in western Europe. Lying off the north-western coast of the European mainland, the United Kingdom includes the island of Great Britain, Northern Ireland is the only part of the United Kingdom that shares a land border with another sovereign state—the Republic of Ireland. The Irish Sea lies between Great Britain and Ireland, with an area of 242,500 square kilometres, the United Kingdom is the 78th-largest sovereign state in the world and the 11th-largest in Europe. It is also the 21st-most populous country, with an estimated 65.1 million inhabitants, together, this makes it the fourth-most densely populated country in the European Union. The United Kingdom is a monarchy with a parliamentary system of governance. The monarch is Queen Elizabeth II, who has reigned since 6 February 1952, other major urban areas in the United Kingdom include the regions of Birmingham, Leeds, Glasgow, Liverpool and Manchester. The United Kingdom consists of four countries—England, Scotland, Wales, the last three have devolved administrations, each with varying powers, based in their capitals, Edinburgh, Cardiff and Belfast, respectively. The relationships among the countries of the UK have changed over time, Wales was annexed by the Kingdom of England under the Laws in Wales Acts 1535 and 1542. A treaty between England and Scotland resulted in 1707 in a unified Kingdom of Great Britain, which merged in 1801 with the Kingdom of Ireland to form the United Kingdom of Great Britain and Ireland. Five-sixths of Ireland seceded from the UK in 1922, leaving the present formulation of the United Kingdom of Great Britain, there are fourteen British Overseas Territories. These are the remnants of the British Empire which, at its height in the 1920s, British influence can be observed in the language, culture and legal systems of many of its former colonies. The United Kingdom is a country and has the worlds fifth-largest economy by nominal GDP. The UK is considered to have an economy and is categorised as very high in the Human Development Index. It was the worlds first industrialised country and the worlds foremost power during the 19th, the UK remains a great power with considerable economic, cultural, military, scientific and political influence internationally. It is a nuclear weapons state and its military expenditure ranks fourth or fifth in the world. The UK has been a permanent member of the United Nations Security Council since its first session in 1946 and it has been a leading member state of the EU and its predecessor, the European Economic Community, since 1973. However, on 23 June 2016, a referendum on the UKs membership of the EU resulted in a decision to leave. The Acts of Union 1800 united the Kingdom of Great Britain, Scotland, Wales and Northern Ireland have devolved self-government
10.
Halfway house
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The environment features varying degrees of privacy, social work, medical, psychiatric, and other similar services as well as residence halls for the patients. Two main types are found in the U. S, in the first type, upon admission, a patient is classified as to the type of disability, ability to reintegrate into society, and expected time frame for doing so. Halfway houses are meant for reintegration of persons who have recently released from jail or a mental institution. There is often opposition from neighborhoods where halfway houses attempt to locate, there are several different types of halfway houses. Some are state sponsored, while others are run by for profit entities, in criminology the purpose of a halfway house is generally considered to be that of allowing people to begin the process of reintegration with society, while still providing monitoring and support. This type of living arrangement is believed to reduce the risk of recidivism or relapse when compared to a straight release directly into society. The state-placement of ex-criminal offenders to a house after a prison sentence may either be decided upon as part of the judges sentence or by a prison officials recommendation. A direct sentence to a house can be decided upon by a judge or prosecutor in lieu of prison time. Most programs in the United States make a distinction between a house and a sober/recovery house. Residents stay for one to six months, residents of work release housing are frequently required to pay rent on a sliding scale which is often dependent on whether or not they can find a job while in residence. In addiction-recovery houses, a stay is sometimes financed by health insurance. In addition, a stay in a house might be a partial requirement of a criminal sentence. Residents are normally asked to remain sober and comply with a recovery program, in certain areas, a halfway house is much different from a recovery house or sober house. In these areas, a Drug and Alcohol Halfway House is licensed by the Department of Health and has staff coverage 24 hours a day and this staff includes a clinical treatment team. In the United Kingdom, halfway house usually refers to a place people with mental disorders, victims of child abuse, orphans. The latter are run by charities, including the Church of England, other churches. Residential places for offenders on bail are known as bail hostels, however, the expression halfway house more usually refers to something combining features of two other things, for example a solution to a problem based on two ideas. In Canada, halfway houses are often called Community-Based Residential Facilities, the Correctional Service of Canada definition of a halfway house is similar to the general American definition of one
11.
The Retreat
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The Retreat, commonly known as the York Retreat, is a place in England for the treatment of people with mental health needs. Located in Lamel Hill in York, it operates as a not for profit charitable organisation, opened in 1796, it is famous for having pioneered the so-called moral treatment that became a model for asylums around the world. Founded by William Tuke, it was run by and for Quakers. It inspired other progressive facilities such as the US Brattleboro Retreat, Hartford Retreat, the present day retreat seeks to retain the essence of early moral treatment, while applying the principles to a modern healthcare setting. A common belief at the time was that the mad were wild beasts, but the Quakers maintained that the humanity and inner light of a person could never be extinguished. A trigger was the death in 1790 of a Quaker, Hannah Mills, the asylum had not let her friends or family visit her, and they became suspicious. Visiting afterwards to investigate the conditions, the Quakers found that the patients were treated worse than animals, Quaker William Tuke was enlisted and took charge of a project to develop a new form of asylum. He appealed to Quakers, personal acquaintances and physicians for funds and he spent two years in discussion with, and issuing explanatory statements to, the local Quaker group, working out the fundamental principles of the proposed institution. Tuke and his physician, Timothy Maud, educated themselves about the current views on madness. Tukes conviction, however, was in the importance of benevolence, Tuke also worked with architect John Bevans to design the new building. The retreat opened in 1796 in the countryside outside York and it was planned to take in about 30 people but started with just three, then eight. Unlike mental institutions of the time, there were no chains or manacles, treatment was based on personalised attention and benevolence, restoring the self-esteem and self-control of residents. An early example of occupational therapy was introduced, including walks and farm labouring in pleasant, There was a social environment where residents were seen as part of a large family-like unit, built on kindness, moderation, order and trust. There was a dimension, including prayer. Inmates were accepted as potentially rational beings who could recover proper social conduct through self-restraint and they were permitted to wear their own clothing, and encouraged to engage in handicrafts, to write, and to read books. They were allowed to wander freely around The Retreats courtyards and gardens, There was some minimised use of restraint. Door locks were encased in leather, the bars on windows made to look like window frames, straitjackets were sometimes used, at least initially, as a threat or a last resort There was little formal medical involvement and an apothecary, Thomas Fowler, served as physician. He gave the medical treatments ample trial but reluctantly and courageously abandoned them as failures
12.
William Tuke
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William Tuke was an English businessman, philanthropist and Quaker. He was instrumental in the development of more humane methods in the custody and care of people with mental disorders, William Tuke was born on 24 March 1732 in York into a prominent Quaker family. His father, Samuel, was a stuff-weaver and shopkeeper who passed away when Tuke was 16 and his mother, Ann, died seven years later. Tuke attended boarding school for two to three years after which he pursued further studies under clergymen, at age 14, he began an apprenticeship at his aunt’s wholesale tea business, which he inherited upon her death in 1752. Tuke married Elizabeth Hoyland in 1754 and fathered four children, after Elizabeth died giving birth of their fifth child, Tuke met and married Esther Maud in 1765. Tuke and his wife were involved in the Friends community. For five decades, he travelled to London for Yearly Meeting, during this time, Tuke remained involved in the family business alongside his eldest son and business partner, Henry. In 1791, William Tuke was moved by an incident involving Hannah Mills, although the cause of her death was not determined, mistreatment was suspected, and the managers had forbade Mills from having any visitors. Tuke’s daughter, Ann, proposed the idea of an institution run by Quakers for their own members. At a Society of Friends meeting in March 1782, Tuke presented his plan for those who “laboured under that most afflictive dispensation – the loss of reason. ”However, the proposal was met with significant opposition. Some members felt that the creation of such an institution was unnecessary, a small minority of supporters included Tuke’s son, Henry, and grammarian Lindley Murray. During a visit to St. Luke’s Hospital in London, Tuke witnessed the conditions in which patients were kept. He was particularly affected by a naked, female patient who had been chained to a wall, Tuke believed that the abuse was not the result of cruel intent but rather a lack of effective alternatives. By 1795, financial and social support from the community was still limited, the Society of Friends eventually approved the plan when Tuke’s friend, Lindley Murray, suggested raising funds through annuities. Tuke bought an 11-acre for £938 and worked closely with London architect John Bevans to carry out his vision for the new asylum. Unlike other institutions of the time, York Retreat featured long, a month after the first patients arrived in June 1796, the unexpected death of superintendent Timothy Maud forced Tuke to step in and run the Retreat himself. William Tuke allowed his doctors to make their own observations and apply them to their practice, bleeding and other traditional remedies were abandoned in favor of gentler methods, such as warm baths for patients with melancholia. Tuke believed that physical and mental health were inextricably linked and emphasized the importance of a proper diet and he sought to instill a sense of reason, not fear, and limited the use of physical restraints
13.
Psychiatry
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Psychiatry is the medical specialty devoted to the diagnosis, prevention, study, and treatment of mental disorders. These include various abnormalities related to mood, behaviour, cognition, initial psychiatric assessment of a person typically begins with a case history and mental status examination. Physical examinations and psychological tests may be conducted, on occasion, neuroimaging or other neurophysiological techniques are used. The fifth edition of the DSM was published in 2013, assertive community treatment, community reinforcement, and supported employment. Treatment may be delivered on an inpatient or outpatient basis, depending on the severity of functional impairment or on aspects of the disorder in question. The term psychiatry was first coined by the German physician Johann Christian Reil in 1808, a medical doctor specializing in psychiatry is a psychiatrist. Psychiatry refers to a field of medicine focused specifically on the mind, aiming to study, prevent and it has been described as an intermediary between the world from a social context and the world from the perspective of those who are mentally ill. People who specialize in psychiatry often differ from most other health professionals. The discipline studies the operations of different organs and body systems as classified by the subjective experiences. Psychiatry treats mental disorders, which are divided into three very general categories, mental illnesses, severe learning disabilities, and personality disorders. While the focus of psychiatry has changed little over time, the diagnostic and treatment processes have evolved dramatically, since the late 20th century the field of psychiatry has continued to become more biological and less conceptually isolated from other medical fields. Psychiatrists can therefore counsel patients, prescribe medication, order laboratory tests, order neuroimaging, like other purveyors of professional ethics, the World Psychiatric Association issues an ethical code to govern the conduct of psychiatrists. The psychiatric code of ethics, first set forth through the Declaration of Hawaii in 1977, has expanded through a 1983 Vienna update and, in 1996. The code was revised during the organizations general assembblies in 1999,2002,2005. Discredited psychiatrists who operated outside the norms of medical ethics include Harry Bailey, Donald Ewen Cameron, Samuel A. Cartwright, Henry Cotton, Psychiatric illnesses can be conceptualised in a number of different ways. The biomedical approach examines signs and symptoms and compares them with diagnostic criteria, Mental illness can be assessed, conversely, through a narrative which tries to incorporate symptoms into a meaningful life history and to frame them as responses to external conditions. The notion of a model is often used to underline the multifactorial nature of clinical impairment. In this notion the word model is not used in a scientific way though
14.
Baghdad
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Baghdad is the capital of the Republic of Iraq. The population of Baghdad, as of 2016, is approximately 8,765,000 making it the largest city in Iraq, the second largest city in the Arab world, and the second largest city in Western Asia. Located along the Tigris River, the city was founded in the 8th century, within a short time of its inception, Baghdad evolved into a significant cultural, commercial, and intellectual center for the Islamic world. This, in addition to housing several key institutions, garnered the city a worldwide reputation as the Centre of Learning. Throughout the High Middle Ages, Baghdad was considered to be the largest city in the world with a population of 1,200,000 people. The city was destroyed at the hands of the Mongol Empire in 1258, resulting in a decline that would linger through many centuries due to frequent plagues. With the recognition of Iraq as an independent state in 1938, in contemporary times, the city has often faced severe infrastructural damage, most recently due to the 2003 invasion of Iraq, and the subsequent Iraq War that lasted until December 2011. In recent years, the city has been subjected to insurgency attacks. As of 2012, Baghdad was listed as one of the least hospitable places in the world to live, the site where the city of Baghdad developed has been populated for millennia. By the 8th century AD, several villages had developed there, including a Persian hamlet called Baghdad, the name is of Indo-European origin and a Middle Persian compound of Bagh god and dād given by, translating to Bestowed by God or Gods gift. In Old Persian the first element can be traced to boghu and is related to Slavic bog god, a similar term in Middle Persian is the name Mithradāt, known in English by its Hellenistic form Mithridates, meaning gift of Mithra. There are a number of locations in the wider region whose names are compounds of the word bagh, including Baghlan. The name of the town Baghdati in Georgia shares the same etymological origins, when the Abbasid caliph, al-Mansur, founded a completely new city for his capital, he chose the name Madinat al-Salaam or City of Peace. This was the name on coins, weights, and other official usage. By the 11th century, Baghdad became almost the exclusive name for the world-renowned metropolis, after the fall of the Umayyads, the first Muslim dynasty, the victorious Abbasid rulers wanted their own capital whence they could rule. They chose a site north of the Sassanid capital of Ctesiphon, on 30 July 762, the caliph Al-Mansur commissioned the construction of the city, mansur believed that Baghdad was the perfect city to be the capital of the Islamic empire under the Abbasids. Mansur loved the site so much he is quoted saying, This is indeed the city that I am to found, where I am to live, and where my descendants will reign afterward. The citys growth was helped by its excellent location, based on at least two factors, it had control over strategic and trading routes along the Tigris, the abundance of water in a dry climate
15.
Al-Walid ibn Abd al-Malik
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Al-Walid ibn Abd al-Malik or Al-Walid I was an Umayyad Caliph who ruled from 705 until his death in 715. His reign saw the greatest expansion of the Caliphate, as successful campaigns were undertaken in Transoxiana in Central Asia, Sind, Hispania in far western Europe and he was born to Abd al-Malik ibn Marwan and his wife who was from the central Arabian region of Najd. Al-Walid was born in 668 and died in 715, Walid continued the expansion of the Islamic empire that was sparked by his father and was an effective ruler. His father Abd al-Malik had taken the oath of allegiance for Walid during his lifetime, as such the succession of Walid was not contested. His reign was marked by a number of conquests in both the east and west with historians considering his reign as the apex of Islamic power, Walid was married to his first cousin Umm Banin bint Abd al-Aziz ibn Marwan. Walid was succeeded by his brother Sulayman and was buried in Bab al-Saghir cemetery in Damascus and his grave is still present to this date. Walid continued his fathers policies of expanding Islamic power through conquests, in 711, Muslim armies crossed the Strait of Gibraltar and began to conquer the Iberian Peninsula using North African Berber troops. By 716, the Visigoths of Iberia had been defeated and Iberia was under Muslim control, in the east, Islamic armies made it as far as the Indus River in 712. Under Walid, the Caliphate stretched from the Iberian Peninsula to India, Al-Hajjaj ibn Yusuf continued to play a crucial role in the organization and selection of military commanders in the East, serving as effectively the viceroy there. Walid paid great attention to the development and expansion of a well-organized military and he built the strongest navy of the Umayyad era which was a key element in Caliphates expansion into Iberia. Like his father, Walid continued to allow Al-Hajjaj ibn Yusuf free rein, musa ibn Nusayr and his retainer Tariq ibn Ziyad conquered Al-Andalus, whilst Mohammad Bin Qasim Conquered Sindh. Hajjaj was responsible for picking the generals who led the eastern campaigns. Others, such as Walids brother Maslamah, advanced against the Byzantines, muhammad ibn Jarir al-Tabari describes how Qutayba ibn Muslim, Khurasans governor, led forces extending the Caliphate to the east. Qutayba conquered Samarkand, advanced into Farghana and sent envoys to China, al-Tabari records how Hajjaj tortured Yazid ibn al-Muhallab. Yazid escaped and made his way to Walids brother Sulayman ibn Abd al-Malik who granted him refuge, Hajjaj pressed Walid about this and Walid commanded Sulayman to send him Yazid in chains. Sulayman had his own son approach Walid chained to Yazid and spoke in favour of Yazids safety, Walid accepted this and told Hajjaj to desist. Walid began the first major building projects of Islam, the history of Islamic architecture can be said to have begun in earnest with Walid. Around 701, al-Walid ordered the building of Al-Aqsa Mosque, opposite his fathers Dome of the Rock on the Temple Mount, Walid repaired and refurbished Masjid al Nabawi in Medina
16.
Cairo
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Cairo is the capital and largest city of Egypt. Cairo has long been a center of the political and cultural life. Cairo has the oldest and largest film and music industries in the Arab world, as well as the worlds second-oldest institution of higher learning, Al-Azhar University. Many international media, businesses, and organizations have regional headquarters in the city, with a population of 6.76 million spread over 453 square kilometers, Cairo is by far the largest city in Egypt. An additional 9.5 million inhabitants live in proximity to the city. Cairo, like many other mega-cities, suffers from high levels of pollution, Cairos metro, one of only two in Africa, ranks among the fifteen busiest in the world, with over 1 billion annual passenger rides. The economy of Cairo was ranked first in the Middle East in 2005, Egyptians often refer to Cairo as Maṣr, the Egyptian Arabic name for Egypt itself, emphasizing the citys importance for the country. In Coptic the city is known as Kahire, meaning Place of the Sun, possibly referring to the ancient city of Heliopolis, the location of the ancient city is the suburb of Ain Shams. The ancient Egyptian name for the area is thought to be Khere-Ohe, The Place of Combat, sometimes the city is informally referred to as Kayro. The area around present-day Cairo, especially Memphis, had long been a point of Ancient Egypt due to its strategic location just upstream from the Nile Delta. However, the origins of the city are generally traced back to a series of settlements in the first millennium. Around the turn of the 4th century, as Memphis was continuing to decline in importance and this fortress, known as Babylon, remained the nucleus of the Roman, and, later, the Byzantine, city and is the oldest structure in the city today. It is also situated at the nucleus of the Coptic Orthodox community, many of Cairos oldest Coptic churches, including the Hanging Church, are located along the fortress walls in a section of the city known as Coptic Cairo. Following the Muslim conquest in 640 AD the conqueror Amr ibn As settled to the north of the Babylon in an area became known as al-Fustat. Originally a tented camp Fustat became a permanent settlement and the first capital of Islamic Egypt, in 750, following the overthrow of the Ummayad caliphate by the Abbasids, the new rulers created their own settlement to the northeast of Fustat which became their capital. This was known as al-Askar as it was laid out like a military camp, a rebellion in 869 by Ahmad ibn Tulun led to the abandonment of Al Askar and the building of another settlement, which became the seat of government. This was al-Qattai, to the north of Fustat and closer to the river, Al Qattai was centred around a palace and ceremonial mosque, now known as the Mosque of ibn Tulun. In 905 the Abbasids re-asserted control of the country and their returned to Fustat
17.
Damascus
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Damascus is the capital and likely the largest city of Syria, following the decline in population of Aleppo due to the ongoing battle for the city. It is commonly known in Syria as ash-Sham and nicknamed as the City of Jasmine, in addition to being one of the oldest continuously inhabited cities in the world, Damascus is a major cultural and religious centre of the Levant. The city has an population of 1,711,000 as of 2009. Located in south-western Syria, Damascus is the centre of a metropolitan area of 2.6 million people. The Barada River flows through Damascus, first settled in the second millennium BC, it was chosen as the capital of the Umayyad Caliphate from 661 to 750. After the victory of the Abbasid dynasty, the seat of Islamic power was moved to Baghdad, Damascus saw a political decline throughout the Abbasid era, only to regain significant importance in the Ayyubid and Mamluk periods. Today, it is the seat of the government and all of the government ministries. The name of Damascus first appeared in the geographical list of Thutmose III as T-m-ś-q in the 15th century BC, the etymology of the ancient name T-m-ś-q is uncertain, but it is suspected to be pre-Semitic. It is attested as Dimašqa in Akkadian, T-ms-ḳw in Egyptian, Dammaśq in Old Aramaic, the Akkadian spelling is found in the Amarna letters, from the 14th century BC. Later Aramaic spellings of the name include a intrusive resh, perhaps influenced by the root dr. Thus, the English and Latin name of the city is Damascus which was imported from originated from the Qumranic Darmeśeq, and Darmsûq in Syriac, meaning a well-watered land. In Arabic, the city is called Dimašqu š-Šāmi, although this is shortened to either Dimašq or aš-Šām by the citizens of Damascus, of Syria and other Arab neighbours. Aš-Šām is an Arabic term for Levant and for Syria, the latter, the Anti-Lebanon mountains mark the border between Syria and Lebanon. The range has peaks of over 10,000 ft. and blocks precipitation from the Mediterranean sea, however, in ancient times this was mitigated by the Barada River, which originates from mountain streams fed by melting snow. Damascus is surrounded by the Ghouta, irrigated farmland where many vegetables, cereals, maps of Roman Syria indicate that the Barada river emptied into a lake of some size east of Damascus. Today it is called Bahira Atayba, the hesitant lake, because in years of severe drought it does not even exist, the modern city has an area of 105 km2, out of which 77 km2 is urban, while Jabal Qasioun occupies the rest. The old city of Damascus, enclosed by the city walls, to the south-east, north and north-east it is surrounded by suburban areas whose history stretches back to the Middle Ages, Midan in the south-west, Sarouja and Imara in the north and north-west. These neighbourhoods originally arose on roads leading out of the city and these new neighbourhoods were initially settled by Kurdish soldiery and Muslim refugees from the European regions of the Ottoman Empire which had fallen under Christian rule
18.
Music therapy
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Neurologic music therapy is the therapeutic application of music to cognitive, sensory, and motor dysfunctions that come from human neurologic diseases. NMT treatment is based on stimulating music perception and production parts in the brain. Here are seven common neurologic dysfunctions categorized into one of four domains that are motor, sensory, cognitive, for each dysfunction, specific parts of the brain are impaired, and the corresponding locations of the brain are denoted with Brodmann area numbers. In neuroscience, a Brodmann area is a way to express different regions of cerebral cortex based on diverse cortical functions. Motor dysfunction involves malfunctioning of the system controlling muscles and movement of body. For stroke patients, the circuit has a difficult time being activated by itself. Using music-supported therapy, their motor circuit can be co-activated along with auditory cortex and this therapy is based on neuroplasticity, the capacity of brain to induce plastic changes and repair damaged brains of adults. After brain damage, new connections and pathways can be built, reshaped. Music-supported therapy has developed recently to improve the upper extremity function of stroke patients. Patients learn to play electronic pianos and electronic drums, each serving as a training method for fine. An intensive one-month program is conducted on stroke patients which teaches them to move their upper extremities in sync along with the song. After finishing this program, chronic stroke patients showed significant motor improvements in Action Research Arm Test, there was partial re-establishment of the default dynamics of the motor circuit, and this is induced by auditory-motor network co-activation. Also, after finishing this program, the song was played to these patients. From this fMRI study, researchers discovered bilateral activation of both auditory and motor circuits, stroke patients can improve on initiating movements by music-supported therapy which utilizes auditory cortex for co-activation of motor circuit system. An experiment was done on cats to prove rescue effect of enriched acoustic environment from hearing loss, fourteen short-hair, wild-type cats were exposed to a traumatizing noise of high frequency around 40 dB for two hours as an experimental group. As a result of the exposure, significant damage is observed in the frequency region of cochlea. This decrease in firing rates shifts the cortical tonotopic map toward a lower frequency range and this reorganization of cortical tonotopic map can result in tinnitus or phantom sound. After this impairment, half of the cats were placed in a room
19.
Medication
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A pharmaceutical drug is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy is an important part of the field and relies on the science of pharmacology for continual advancement. Drugs are classified in various ways, one of the key divisions is by level of control, which distinguishes prescription drugs from over-the-counter drugs. Other ways to classify medicines are by mode of action, route of administration, biological system affected, an elaborate and widely used classification system is the Anatomical Therapeutic Chemical Classification System. The World Health Organization keeps a list of essential medicines, Drug discovery and drug development are complex and expensive endeavors undertaken by pharmaceutical companies, academic scientists, and governments. Governments generally regulate what drugs can be marketed, how drugs are marketed, controversies have arisen over drug pricing and disposal of used drugs. In the US, a drug is, A substance recognized by an official pharmacopoeia or formulary, a substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease. A substance intended to affect the structure or any function of the body, a substance intended for use as a component of a medicine but not a device or a component, part or accessory of a device. Pharmaceutical or a drug is classified on the basis of their origin, Drug from natural origin, Herbal or plant or mineral origin, some drug substances are of marine origin. Drug from chemical as well as origin, Derived from partial herbal and partial chemical synthesis Chemical. Drug derived from animal origin, For example, hormones, Drug derived from microbial origin, Antibiotics Drug derived by biotechnology genetic-engineering, hybridoma technique for example Drug derived from radioactive substances. An elaborate and widely used system is the Anatomical Therapeutic Chemical Classification System. The World Health Organization keeps a list of essential medicines, the main classes of painkillers are NSAIDs, opioids and Local anesthetics. For consciousness Some anesthetics include Benzodiazepines and Barbiturates, the main categories of drugs for musculoskeletal disorders are, NSAIDs, muscle relaxants, neuromuscular drugs, and anticholinesterases. Euthanasia is not permitted by law in countries, and consequently medicines will not be licensed for this use in those countries. Administration is the process by which a patient takes a medicine, there are three major categories of drug administration, enteral, parenteral, and other. It can be performed in various forms such as pills, tablets. There are many variations in the routes of administration, including intravenous and they can be administered all at once as a bolus, at frequent intervals or continuously
20.
Philippe Pinel
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He also made notable contributions to the classification of mental disorders and has been described by some as the father of modern psychiatry. Pinel was born in the hills of Jonquières, France. He was the son and nephew of physicians, after receiving a degree from the faculty of medicine in Toulouse, he studied an additional four years at the Faculty of Medicine of Montpellier. He arrived in Paris in 1778 and he spent fifteen years earning his living as a writer, translator, and editor because the restrictive regulations of the old regime prevented him from practicing medicine in Paris. The faculty did not recognize a degree from a university like Toulouse. He failed twice in a competition which would have awarded him funds to continue his studies, discouraged, Pinel considered emigrating to America. In 1784 he became editor of the not very prestigious medical journal the Gazette de santé and he was also known among natural scientists as a regular contributor to the Journal de physique. He studied mathematics, translated works into French, and undertook botanical expeditions. At about this time he began to develop an intense interest in the study of mental illness, the incentive was a personal one. A friend had developed a ‘nervous melancholy’ that had ‘degenerated into mania’, what Pinel regarded as an unnecessary tragedy due to gross mismanagement seems to have haunted him. It led him to employment at one of the best-known private sanatoria for the treatment of insanity in Paris. He remained there for five years prior to the Revolution, gathering observations on insanity and beginning to formulate his views on its nature, Pinel was an Ideologue, a disciple of the abbé de Condillac. He was also a clinician who believed that truth was derived from clinical experience. During the 1780s, Pinel was invited to join the salon of Madame Helvétius and he was in sympathy with the French Revolution. After the revolution, friends he had met at Madame Helvétius’ salon came to power, in August 1793 Pinel was appointed physician of the infirmeries at Bicêtre Hospital. At the time it housed about four thousand imprisoned men—criminals, petty offenders, syphilitics, pensioners, pinel’s patrons hoped that his appointment would lead to therapeutic initiatives. His experience at the private sanatoria made him a candidate for the job. Soon after his appointment to lHôpital Bicêtre, Pinel became interested in the ward where 200 mentally ill men were housed
21.
Institutionalisation
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Institutionalisation refers to the process of embedding some conception within an organization, social system, or society as a whole. The term may also be used to refer to committing a particular individual or group to an institution, thus a person is rarely committed against their will and it is illegal for a person to be committed for an indefinite period of time. Institutionalization is also seen as being an important part of process of modernization in developing countries, involving again the expansion and these were seen as models of social improvement, and many inferior imitations followed for the lower social orders. As late as the 1950s, in Britain, several hundred people lived in Victorian asylums. Jean-Jacques Rousseau wrote in his opus The Social Contract that Slaves lose everything in their chains, even the desire of escaping from them, the modern era of institutionalized provision for the care of the mentally ill began in the early 19th century with a large state-led effort. Public mental asylums were established in Britain after the passing of the 1808 County Asylums Act and this empowered magistrates to build rate-supported asylums in every county to house the many pauper lunatics. Nine counties first applied, and the first public asylum opened in 1812 in Nottinghamshire, however, it was not until 1828 that the newly appointed Commissioners in Lunacy were empowered to license and supervise private asylums. The Lunacy Act 1845 was an important landmark in the treatment of the mentally ill, the Act created the Lunacy Commission, headed by Lord Shaftesbury, to focus on lunacy legislation reform. All asylums were required to have written regulations and to have a resident qualified physician, in 1838, France enacted a law to regulate both the admissions into asylums and asylum services across the country. Édouard Séguin developed an approach for training individuals with mental deficiencies. His method of treatment was based on the assumption that the mentally deficient did not suffer from disease, in the United States, the erection of state asylums began with the first law for the creation of one in New York, passed in 1842. The Utica State Hospital was opened approximately in 1850, the creation of this hospital, as of many others, was largely the work of Dorothea Lynde Dix, whose philanthropic efforts extended over many states, and in Europe as far as Constantinople. Many state hospitals in the United States were built in the 1850s and 1860s on the Kirkbride Plan, at the turn of the century, England and France combined had only a few hundred individuals in asylums. By the late 1890s and early 1900s, this number had risen to the hundreds of thousands, however, the idea that mental illness could be ameliorated through institutionalization was soon disappointed. Psychiatrists were pressured by an increasing patient population. The average number of patients in asylums kept on growing, Asylums were quickly becoming almost indistinguishable from custodial institutions, and the reputation of psychiatry in the medical world had hit an extreme low. The dangers of institutions were chronicled and criticized by reformers almost since their foundation, do not for a moment underestimate their powers of resistance to our assault. Let me describe some of the defenses which we have to storm, scandal after scandal followed, with many high-profile public inquiries
22.
County
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A county is a geographical region of a country used for administrative or other purposes, in certain modern nations. The term is derived from the Old French conté or cunté denoting a jurisdiction under the sovereignty of a count or a viscount. The modern French is comté, and its equivalents in other languages are contea, contado, comtat, condado, Grafschaft, graafschap, Gau, when the Normans conquered England, they brought the term with them. The Saxons had already established the districts became the historic counties of England. The Vikings introduced the term earl to the British Isles, thus, the Anglo-Saxons earl and earldom were taken as equivalent to the continental use of count and county under the conquering Normans, and over time the two blended and became equivalent terms. Further, the term became a synonym for the native English word scir or, in Modern English. Since a shire was a division of the kingdom, the term county evolved to designate an administrative division of states or of a national government in most other modern uses. A county may be subdivided into districts, hundreds, townships or other administrative jurisdictions within the county. A county usually, but not always, contains cities, towns, townships, villages, or other municipal corporations, Provinces in Argentina are divided into departments, except in the Buenos Aires Province, where they are called partidos. The Autonomous City of Buenos Aires is divided into communes, in the eastern states of Australia, counties are used in the administration of land titles. They do not generally correspond to a level of government, but are used in the identification of parcels of land, canadas five oldest provinces – New Brunswick, Nova Scotia, Ontario, Quebec and Prince Edward Island – are divided into counties. In addition to counties, Ontario is also subdivided into districts, district municipalities, metropolitan municipalities. British Columbia, Manitoba, Newfoundland and Labrador, Northwest Territories, Nunavut, Saskatchewan, the word county is used to translate the Chinese term xiàn. In Mainland China, governed by the Peoples Republic of China, counties are the level of local government. There are 1,464 counties in the PRC out of a total of 2,862 county-level divisions, the number of counties has remained more or less constant since the Han dynasty. The county remains one of the oldest levels of government in China, the county government was particularly important in imperial China because this was the lowest layer at which the imperial government functioned. The head of a county during imperial times was the magistrate, in older context, prefecture and district are alternative terms to refer to xiàn before the establishment of the Republic of China. The English nomenclature county was adopted following the establishment of the ROC, contrary to the typical rural location of a county in Western countries, a city in China may enclose several counties
23.
Nottinghamshire
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Nottinghamshire is a county in the East Midlands of England, bordering South Yorkshire to the north-west, Lincolnshire to the east, Leicestershire to the south, and Derbyshire to the west. The traditional county town is Nottingham, though the county council is based in West Bridgford in the borough of Rushcliffe, the districts of Nottinghamshire are Ashfield, Bassetlaw, Broxtowe, Gedling, Mansfield, Newark and Sherwood, and Rushcliffe. The City of Nottingham was administratively part of Nottinghamshire between 1974 and 1998 but is now an authority, remaining part of Nottinghamshire for ceremonial purposes. In 2011 the county was estimated to have a population of 785,800, over half of the population of the county live in the Greater Nottingham conurbation. The conurbation has a population of about 650,000, though less than half live within the city boundaries. Nottinghamshire lies on the Roman Fosse Way, and there are Roman settlements in the county, for example at Mansfield, the county was settled by Angles around the 5th century, and became part of the Kingdom, and later Earldom, of Mercia. However, there is evidence of Saxon settlement at the Broxtowe Estate, Oxton, near Nottingham, the name first occurs in 1016, but until 1568 the county was administratively united with Derbyshire, under a single Sheriff. In Norman times the county developed malting and woollen industries, in the 18th and 19th centuries, mechanised deeper collieries opened and mining became an important economic sector, though these declined after the 1984–85 miners strike. Until 1610, Nottinghamshire was divided into eight Wapentakes, sometime between 1610 and 1719 they were reduced to six – Newark, Bassetlaw, Thurgarton, Rushcliffe, Broxtowe and Bingham, some of these names still being used for the modern districts. Oswaldbeck was absorbed in Bassetlaw, of which it forms the North Clay division, Nottinghamshire is famous for its involvement with the legend of Robin Hood. This is also the reason for the numbers of tourists who visit places like Sherwood Forest, City of Nottingham, to reinforce the Robin Hood connection, the University of Nottingham in 2010 has begun the Nottingham Caves Survey with the goal to increase the tourist potential of these sites. The project will use a 3D laser scanner to produce a three dimensional record of more than 450 sandstone caves around Nottingham. Nottinghamshire was mapped first by Christopher Saxton in 1576, the first fully surveyed map of the county was by John Chapman who produced Chapmans Map of Nottinghamshire in 1774. Nottinghamshire, like Derbyshire and South Yorkshire, sits on extensive coal measures, up to 900 metres thick, there is an oilfield near Eakring. These are overlaid by sandstones and limestones in the west and clay in the east, the north of the county is part of the Humberhead Levels lacustrine plain. The centre and south west of the county, around Sherwood Forest, principal rivers are the Trent, Idle, Erewash and Soar. The Trent, fed by the Soar and Erewash, and Idle, composed of many streams from Sherwood Forest, run through wide and flat valleys, the lowest is Peat Carr, east of Blaxton, at sea level, the Trent is tidal below Cromwell Lock. Nottinghamshire is sheltered by the Pennines to the west, so receives relatively low rainfall at 641–740 mm annually, the average temperature of the county is 8. 8–10.1 degrees Celsius
24.
Home Secretary
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The office is a British Cabinet level position. The Home Secretary is responsible for the affairs of England and Wales. The remit of the Home Office also includes policing in England and Wales and matters of security, as the Security Service. The current Home Secretary is Amber Rudd, appointed formally by Queen Elizabeth II on the advice of her Prime Minister Theresa May on 13 July 2016. Mrs. May had been the incumbent, appointed on 12 May 2010 by Prime Minister, David Cameron. May was reappointed by Cameron on 8 May 2015 to serve as Home Secretary in the Conservative government and she stood down from this role on 13 July 2016 upon assuming the office of Prime Minister, succeeding Cameron
25.
Physician
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Both the role of the physician and the meaning of the word itself vary around the world. Degrees and other qualifications vary widely, but there are common elements, such as medical ethics requiring that physicians show consideration, compassion. Around the world the term refers to a specialist in internal medicine or one of its many sub-specialties. This meaning of physician conveys a sense of expertise in treatment by drugs or medications and this term is at least nine hundred years old in English, physicians and surgeons were once members of separate professions, and traditionally were rivals. Henry VIII granted a charter to the London Royal College of Physicians in 1518 and it was not until 1540 that he granted the Company of Barber/Surgeons its separate charter. In the same year, the English monarch established the Regius Professorship of Physic at the University of Cambridge, newer universities would probably describe such an academic as a professor of internal medicine. Hence, in the 16th century, physic meant roughly what internal medicine does now, currently, a specialist physician in the United States may be described as an internist. Another term, hospitalist, was introduced in 1996, to describe US specialists in internal medicine who work largely or exclusively in hospitals, such hospitalists now make up about 19% of all US general internists, who are often called general physicians in Commonwealth countries. In such places, the more general English terms doctor or medical practitioner are prevalent, in Commonwealth countries, specialist pediatricians and geriatricians are also described as specialist physicians who have sub-specialized by age of patient rather than by organ system. Around the world, the term physician and surgeon is used to describe either a general practitioner or any medical practitioner irrespective of specialty. This usage still shows the meaning of physician and preserves the old difference between a physician, as a practitioner of physic, and a surgeon. The term may be used by state medical boards in the United States of America, in modern English, the term physician is used in two main ways, with relatively broad and narrow meanings respectively. This is the result of history and is often confusing and these meanings and variations are explained below. In the United States and Canada, the term physician describes all medical practitioners holding a professional medical degree, the American Medical Association, established in 1847, as well as the American Osteopathic Association, founded in 1897, both currently use the term physician to describe members. However, the American College of Physicians, established in 1915, does not, its title uses physician in its original sense. A physician trained in the United States has either a Doctor of Medicine degree, all boards of certification now require that physicians demonstrate, by examination, continuing mastery of the core knowledge and skills for a chosen specialty. Recertification varies by particular specialty between every seven and every ten years, graduates of osteopathic medical schools in the United States should not be confused with osteopaths, who are trained in the European and Commonwealth nations. Their training is similar to physical therapy and they are not licensed to prescribe medications or perform surgeries, also in the United States, the American Podiatric Medical Association defines podiatrists as physicians and surgeons that fall under the department of surgery in hospitals
26.
Sociology
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Sociology is the study of social behaviour or society, including its origins, development, organisation, networks, and institutions. It is a science that uses various methods of empirical investigation and critical analysis to develop a body of knowledge about social order, disorder. Many sociologists aim to research that may be applied directly to social policy and welfare. Subject matter ranges from the level of individual agency and interaction to the macro level of systems. The traditional focuses of sociology include social stratification, social class, social mobility, religion, secularization, law, sexuality, the range of social scientific methods has also expanded. Social researchers draw upon a variety of qualitative and quantitative techniques, the linguistic and cultural turns of the mid-twentieth century led to increasingly interpretative, hermeneutic, and philosophic approaches towards the analysis of society. There is often a great deal of crossover between social research, market research, and other statistical fields, Sociology is distinguished from various general social studies courses, which bear little relation to sociological theory or to social-science research-methodology. The US National Science Foundation classifies sociology as a STEM field, Sociological reasoning pre-dates the foundation of the discipline. Social analysis has origins in the stock of Western knowledge and philosophy. The origin of the survey, i. e, there is evidence of early sociology in medieval Arab writings. The word sociology is derived from both Latin and Greek origins, the Latin word, socius, companion, the suffix -logy, the study of from Greek -λογία from λόγος, lógos, word, knowledge. It was first coined in 1780 by the French essayist Emmanuel-Joseph Sieyès in an unpublished manuscript, Sociology was later defined independently by the French philosopher of science, Auguste Comte, in 1838. Comte used this term to describe a new way of looking at society, Comte had earlier used the term social physics, but that had subsequently been appropriated by others, most notably the Belgian statistician Adolphe Quetelet. Comte endeavoured to unify history, psychology and economics through the understanding of the social realm. Comte believed a positivist stage would mark the final era, after conjectural theological and metaphysical phases, Comte gave a powerful impetus to the development of sociology, an impetus which bore fruit in the later decades of the nineteenth century. To say this is not to claim that French sociologists such as Durkheim were devoted disciples of the high priest of positivism. To be sure, beginnings can be traced back well beyond Montesquieu, for example, Marx rejected Comtean positivism but in attempting to develop a science of society nevertheless came to be recognized as a founder of sociology as the word gained wider meaning. For Isaiah Berlin, Marx may be regarded as the father of modern sociology
27.
Erving Goffman
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Erving Goffman was a Canadian-American sociologist and writer, considered by some the most influential American sociologist of the twentieth century. Goffman was the 73rd president of the American Sociological Association and his best-known contribution to social theory is his study of symbolic interaction. This took the form of analysis, beginning with his 1956 book. Goffmans other major works include Asylums, Stigma, Interaction Ritual, Frame Analysis, Goffman was born 11 June 1922, in Mannville, Alberta, Canada, to Max Goffman and Anne Goffman, née Averbach. He was from a family of Ukrainian Jews who had emigrated to Canada at the turn of the century and he had an older sibling, Frances Bay, who became an actress. The family moved to Dauphin, Manitoba, where his father operated a tailoring business. From 1937 Goffman attended St. Johns Technical High School in Winnipeg, in 1939 he enrolled at the University of Manitoba, majoring in chemistry. He interrupted his studies and moved to Ottawa to work in the industry for the National Film Board of Canada. Later he developed an interest in sociology, also during this time, he met the renowned North American sociologist, Dennis Wrong. Later he moved to the University of Chicago, where he received an MA, for his doctoral dissertation, from December 1949 to May 1951 he lived and collected ethnographic data on the island of Unst in the Shetland Islands. In 1952 Goffman married Angelica Choate, in 1953, their son Thomas was born, Angelica suffered from mental illness and committed suicide in 1964. Outside his academic career, Goffman was known for his interest, at one point, in pursuit of his hobbies and ethnographic studies, he became a pit boss at a Las Vegas casino. In 1981 Goffman married sociolinguist Gillian Sankoff, the following year, their daughter Alice was born. In 1982 Goffman died in Philadelphia, Pennsylvania, on 19 November, the research that Goffman had done in Unst inspired him to write his first major work, The Presentation of Self in Everyday Life. After graduating from the University of Chicago, in 1954–57 he was an assistant to the director at the National Institute for Mental Health in Bethesda. In 1958 Goffman became a faculty member in the department at the University of California, Berkeley, first as a visiting professor. In 1968 he moved to the University of Pennsylvania, receiving the Benjamin Franklin Chair in Sociology and Anthropology, due largely to the efforts of Dell Hymes, in 1969 he became a fellow of the American Academy of Arts and Sciences. In 1970 Goffman became a cofounder of the American Association for the Abolition of Involuntary Mental Hospitalization, in 1971 he published Relations in Public, in which he tied together many of his ideas about everyday life, seen from a sociological perspective
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Anti-psychiatry
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Anti-psychiatry is the view that psychiatric treatments are often more damaging than helpful to patients, and a movement opposing such treatments for almost two centuries. It considers psychiatry a coercive instrument of oppression due to a power relationship between doctor and patient, and a highly subjective diagnostic process. Anti-psychiatry originates in an objection to what some view as dangerous treatments, examples include electroconvulsive therapy, insulin shock therapy, and brain lobotomy. An immediate concern is the significant increase in prescribing drugs for children. There were also concerns about mental health institutions, all modern societies permit involuntary treatment or involuntary commitment of mental patients. In the 1960s, there were challenges to psychoanalysis and mainstream psychiatry. Psychiatrists involved in this challenge included Jacques Lacan, Thomas Szasz, Giorgio Antonucci, R. D. Laing, Franco Basaglia, Theodore Lidz, Silvano Arieti, others involved were Michel Foucault and Erving Goffman. Cooper coined the term anti-psychiatry in 1967, and wrote the book Psychiatry and Anti-psychiatry in 1971, the first widespread challenge to the prevailing medical approach in Western countries occurred in the late 18th century. Alternatives were developed, led in different regions by ex-patient staff, physicians themselves in some cases, and as it became the establishment approach in the 19th century, opposition to its negative aspects also grew. Another form of treatment involved natures opposite, the theatre, where the patients madness was acted out for him or her in such a way that the delusion would reveal itself to the patient. According to Foucault, the most prominent therapeutic technique instead became to confront patients with a sound will and orthodox passions. The cure then involved a process of opposition, of struggle and domination and it was thought the confrontation would lead not only to bring the illness into broad daylight by its resistance, but also to the victory of the sound will and the renunciation of the disturbed will. We must apply a method, to break the spasm by means of the spasm. We must subjugate the whole character of some patients, subdue their transports, break their pride, while we must stimulate, Foucault summarised these as designed to make the medical personage the master of madness through the power the physicians will exerts on the patient. The effect of this shift then served to inflate the power of the relative to the patient. Other analyses suggest that the rise of asylums was primarily driven by industrialization and capitalism, various 19th-century critiques of the newly emerging field of psychiatry overlap thematically with 20th-century anti-psychiatry, for example in their questioning of the medicalisation of madness. Those critiques occurred at a time when physicians had not yet achieved hegemony through psychiatry, however, so there was no single, nevertheless, there was increasing concern at the ease with which people could be confined, with frequent reports of abuse and illegal confinement. For example, Daniel Defoe, the author of Robinson Crusoe, had argued for more government oversight of madhouses
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Connecticut
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Connecticut is the southernmost state in the New England region of the northeastern United States. Connecticut is also often grouped along with New York and New Jersey as the Tri-State Area and it is bordered by Rhode Island to the east, Massachusetts to the north, New York to the west, and Long Island Sound to the south. Its capital city is Hartford, and its most populous city is Bridgeport, the state is named for the Connecticut River, a major U. S. river that approximately bisects the state. The word Connecticut is derived from various anglicized spellings of an Algonquian word for long tidal river, Connecticut is the third smallest state by area, the 29th most populous, and the fourth most densely populated of the 50 United States. It is known as the Constitution State, the Nutmeg State, the Provisions State, and it was influential in the development of the federal government of the United States. Connecticuts center of population is in Cheshire, New Haven County, Connecticuts first European settlers were Dutch. They established a small, short-lived settlement in present-day Hartford at the confluence of the Park, initially, half of Connecticut was a part of the Dutch colony New Netherland, which included much of the land between the Connecticut and Delaware rivers. The first major settlements were established in the 1630s by England, the Connecticut and New Haven Colonies established documents of Fundamental Orders, considered the first constitutions in North America. In 1662, the three colonies were merged under a charter, making Connecticut a crown colony. This colony was one of the Thirteen Colonies that revolted against British rule in the American Revolution, the Connecticut River, Thames River, and ports along the Long Island Sound have given Connecticut a strong maritime tradition which continues today. The state also has a history of hosting the financial services industry, including insurance companies in Hartford. As of the 2010 Census, Connecticut features the highest per-capita income, Human Development Index, and median household income in the United States. Landmarks and Cities of Connecticut Connecticut is bordered on the south by Long Island Sound, on the west by New York, on the north by Massachusetts, and on the east by Rhode Island. The state capital and third largest city is Hartford, and other cities and towns include Bridgeport, New Haven, Stamford, Waterbury, Norwalk, Danbury, New Britain, Greenwich. Connecticut is slightly larger than the country of Montenegro, there are 169 incorporated towns in Connecticut. The highest peak in Connecticut is Bear Mountain in Salisbury in the northwest corner of the state, the highest point is just east of where Connecticut, Massachusetts, and New York meet, on the southern slope of Mount Frissell, whose peak lies nearby in Massachusetts. At the opposite extreme, many of the towns have areas that are less than 20 feet above sea level. Connecticut has a maritime history and a reputation based on that history—yet the state has no direct oceanfront
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Vienna
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Vienna is the capital and largest city of Austria and one of the nine states of Austria. Vienna is Austrias primary city, with a population of about 1.8 million, and its cultural, economic and it is the 7th-largest city by population within city limits in the European Union. Today, it has the second largest number of German speakers after Berlin, Vienna is host to many major international organizations, including the United Nations and OPEC. The city is located in the part of Austria and is close to the borders of the Czech Republic, Slovakia. These regions work together in a European Centrope border region, along with nearby Bratislava, Vienna forms a metropolitan region with 3 million inhabitants. In 2001, the city centre was designated a UNESCO World Heritage Site, apart from being regarded as the City of Music because of its musical legacy, Vienna is also said to be The City of Dreams because it was home to the worlds first psycho-analyst – Sigmund Freud. The citys roots lie in early Celtic and Roman settlements that transformed into a Medieval and Baroque city and it is well known for having played an essential role as a leading European music centre, from the great age of Viennese Classicism through the early part of the 20th century. The historic centre of Vienna is rich in architectural ensembles, including Baroque castles and gardens, Vienna is known for its high quality of life. In a 2005 study of 127 world cities, the Economist Intelligence Unit ranked the city first for the worlds most liveable cities, between 2011 and 2015, Vienna was ranked second, behind Melbourne, Australia. Monocles 2015 Quality of Life Survey ranked Vienna second on a list of the top 25 cities in the world to make a base within, the UN-Habitat has classified Vienna as being the most prosperous city in the world in 2012/2013. Vienna regularly hosts urban planning conferences and is used as a case study by urban planners. Between 2005 and 2010, Vienna was the worlds number-one destination for international congresses and it attracts over 3.7 million tourists a year. The English name Vienna is borrowed from the homonymous Italian version of the name or the French Vienne. The etymology of the name is still subject to scholarly dispute. Some claim that the name comes from Vedunia, meaning forest stream, which produced the Old High German Uuenia. A variant of this Celtic name could be preserved in the Czech and Slovak names of the city, the name of the city in Hungarian, Serbo-Croatian and Ottoman Turkish has a different, probably Slavonic origin, and originally referred to an Avar fort in the area. Slovene-speakers call the city Dunaj, which in other Central European Slavic languages means the Danube River, evidence has been found of continuous habitation since 500 BC, when the site of Vienna on the Danube River was settled by the Celts. In 15 BC, the Romans fortified the city they called Vindobona to guard the empire against Germanic tribes to the north
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Narrenturm (hospital)
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The Narrenturm in Vienna is continental Europes oldest building for the accommodation of mental patients. Built in 1784, it is next to the site of the old Vienna General Hospital, the Narrenturm was constructed in 1784, under Emperor Joseph II, by Isidore Canevale. It consisted of a five-storey, fortress-like circular building with 28 rooms, there were in total 139 individual cells for the inmates. Each cell had strong, barred doors as well as chains for restraining inmates, with its barracks-like appearance, the tower was a visible expression of the segregation, stigmatisation and criminalisation of socially deviant forms of behaviour. By the late 1790s the tower had already been made obsolete by innovations in the treatment of mental patients. Despite appearances, the Narrenturm was not an implementation of Jeremy Benthams hypothetical panopticon, the towers round shape is the source of the Viennese slang word Gugelhupf for mental asylums and psychiatric clinics. When it was first built, the Narrenturm had a rod or lightning catcher installed on the roof ridge. Two of the supporting fixtures can still be seen in the inner chamber, in that time Václav Prokop Diviš, a clergyman in Přímětice near Znojmo, had studied plant growth and healing with electrical currents present, publishing his findings to the medical community. The tower is home to the Federal Pathologic-Anatomical Museum, founded by Emperor Francis II in 1796 as the Museum of the Pathologic-Anatomical Institute. It has been a museum since 1974. Electro-Pathological Museum Parts of the former Electro-Pathological Museum, founded in 1936 by Stefan Jellinek, are housed here, Jellinek was forced to leave the country in 1939, but regained his old collection after the war. A new exhibition was created after Jellineks death in 1968 by his colleague Franz Maresch, in the 1980s the Technisches Museum Wien took over a large part of the collection, while its preserved human and animal exhibits were transferred to the Pathologic-Anatomical Museum. Faszination und Ekel Das Pathologisch-anatomische Bundesmuseum im Wiener Narrenturm, der Narrenturm oder Die dunkle Seite der Wissenschaft. Das pathologisch-anatomische Bundesmuseum im Narrenturm des alten Allgemeinen Krankenhauses in Wien, Pathologic-Anatomical Museum, including history of the museum History of psychiatric institutions
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German language
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German is a West Germanic language that is mainly spoken in Central Europe. It is the most widely spoken and official language in Germany, Austria, Switzerland, South Tyrol, the German-speaking Community of Belgium and it is also one of the three official languages of Luxembourg. Major languages which are most similar to German include other members of the West Germanic language branch, such as Afrikaans, Dutch, English, Luxembourgish and it is the second most widely spoken Germanic language, after English. One of the languages of the world, German is the first language of about 95 million people worldwide. The German speaking countries are ranked fifth in terms of publication of new books. German derives most of its vocabulary from the Germanic branch of the Indo-European language family, a portion of German words are derived from Latin and Greek, and fewer are borrowed from French and English. With slightly different standardized variants, German is a pluricentric language, like English, German is also notable for its broad spectrum of dialects, with many unique varieties existing in Europe and also other parts of the world. The history of the German language begins with the High German consonant shift during the migration period, when Martin Luther translated the Bible, he based his translation primarily on the standard bureaucratic language used in Saxony, also known as Meißner Deutsch. Copies of Luthers Bible featured a long list of glosses for each region that translated words which were unknown in the region into the regional dialect. Roman Catholics initially rejected Luthers translation, and tried to create their own Catholic standard of the German language – the difference in relation to Protestant German was minimal. It was not until the middle of the 18th century that a widely accepted standard was created, until about 1800, standard German was mainly a written language, in urban northern Germany, the local Low German dialects were spoken. Standard German, which was different, was often learned as a foreign language with uncertain pronunciation. Northern German pronunciation was considered the standard in prescriptive pronunciation guides though, however, German was the language of commerce and government in the Habsburg Empire, which encompassed a large area of Central and Eastern Europe. Until the mid-19th century, it was essentially the language of townspeople throughout most of the Empire and its use indicated that the speaker was a merchant or someone from an urban area, regardless of nationality. Some cities, such as Prague and Budapest, were gradually Germanized in the years after their incorporation into the Habsburg domain, others, such as Pozsony, were originally settled during the Habsburg period, and were primarily German at that time. Prague, Budapest and Bratislava as well as cities like Zagreb, the most comprehensive guide to the vocabulary of the German language is found within the Deutsches Wörterbuch. This dictionary was created by the Brothers Grimm and is composed of 16 parts which were issued between 1852 and 1860, in 1872, grammatical and orthographic rules first appeared in the Duden Handbook. In 1901, the 2nd Orthographical Conference ended with a standardization of the German language in its written form
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