352 BUMC PROCEEDINGS 2001;14:352–357
The technological advances of the past century tended tochange the focus of medicine from a caring, service-oriented model to a technological, cure-oriented model.
Technology has led to phenomenal advances in medicine and
has given us the ability to prolong life. However, in the past few
decades physicians have attempted to balance their care by re-
claiming medicine’s more spiritual roots, recognizing that until
modern times spirituality was often linked with health care.
Spiritual or compassionate care involves serving the whole per-
son—the physical, emotional, social, and spiritual. Such service
is inherently a spiritual activity. Rachel Naomi Remen, MD, who
has developed Commonweal retreats for people with cancer, de-
scribed it well:
Helping, fixing, and serving represent three different ways of see-
ing life. When you help, you see life as weak. When you fix, you
see life as broken. When you serve, you see life as whole. Fixing
and helping may be the work of the ego, and service the work of
the soul (1).
Serving patients may involve spending time with them, hold-
ing their hands, and talking about what is important to them.
Patients value these experiences with their physicians. In this
article, I discuss elements of compassionate care, review some
research on the role of spirituality in health care, highlight ad-
vantages of understanding patients’ spirituality, explain ways to
practice spiritual care, and summarize some national efforts to
incorporate spirituality into medicine.
COMPASSIONATE CARE: HELPING PATIENTS FIND MEANING IN
THEIR SUFFERING AND ADDRESSING THEIR SPIRITUALITY
The word compassion means “to suffer with.” Compassionate
care calls physicians to walk with people in the midst of their
pain, to be partners with patients rather than experts dictating
information to them.
Victor Frankl, a psychiatrist who wrote of his experiences in
a Nazi concentration camp, wrote: “Man is not destroyed by suf-
fering; he is destroyed by suffering without meaning” (2). One
of the challenges physicians face is to help people find meaning
and acceptance in the midst of suffering and chronic illness.
Medical ethicists have reminded us that religion and spiritual-
ity form the basis of meaning and purpose for many people (3).
At the same time, while patients struggle with the physical as-
pects of their disease, they have other pain as well: pain related
to mental and spiritual suffering, to an inability to engage the
deepest questions of life. Patients may be asking questions such
The role of spirituality in health care
CHRISTINA M. PUCHALSKI, MD, MS
From The George Washington Institute for Spirituality and Health (GWish), The
George Washington University Medical Center Departments of Medicine and
Health Care Sciences, and The George Washington University, Washington, DC.
Presented at Baylor University Medical Center on February 28, 2001, as the Baylor-
Charles A. Sammons Cancer Center Charlotte ...
Abstract— Spiritual or compassionate care involves serving the whole person i.e. physical, emotional, social, spiritual etc dimensions of health. Spirituality has now been identified globally as an important aspect for providing answers to many questions related to health and happiness. The World Health Organization is also looking beyond physical, mental and social dimensions of the health i.e. the spiritual health and its impact on the overall health and happiness of an individual. Spiritual commitment tends to enhance recovery from illness and surgery also. Spiritually is transpired both in order to comfort the dying and to broaden one's own understanding of life at its ending. Spiritual beliefs can help patients cope with disease and face death. So it should be necessarily be add-on in critical stage of disease. Nowadays in some of medical schools in developed countries has included as a curreculam of patient care. Now it is the time that all Medical Colleges should include educating their students about spiritual health care in comprehensive patient care. Medical Council of India should also take some action in this direction.
Annals of Surgery and Perioperative Care is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Surgery.
The journal aims to promote latest information and provide a forum for doctors, researchers, physicians, and healthcare professionals to find most recent advances in the areas of Surgery. Annals of Surgery and Perioperative Care accepts research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Surgery.
Annals of Surgery and Perioperative Care strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing.
Abstract— Spiritual or compassionate care involves serving the whole person i.e. physical, emotional, social, spiritual etc dimensions of health. Spirituality has now been identified globally as an important aspect for providing answers to many questions related to health and happiness. The World Health Organization is also looking beyond physical, mental and social dimensions of the health i.e. the spiritual health and its impact on the overall health and happiness of an individual. Spiritual commitment tends to enhance recovery from illness and surgery also. Spiritually is transpired both in order to comfort the dying and to broaden one's own understanding of life at its ending. Spiritual beliefs can help patients cope with disease and face death. So it should be necessarily be add-on in critical stage of disease. Nowadays in some of medical schools in developed countries has included as a curreculam of patient care. Now it is the time that all Medical Colleges should include educating their students about spiritual health care in comprehensive patient care. Medical Council of India should also take some action in this direction.
Annals of Surgery and Perioperative Care is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Surgery.
The journal aims to promote latest information and provide a forum for doctors, researchers, physicians, and healthcare professionals to find most recent advances in the areas of Surgery. Annals of Surgery and Perioperative Care accepts research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Surgery.
Annals of Surgery and Perioperative Care strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing.
Henrietta Ayinor Topic 1 DQ 1Spirituality in my worldview has SusanaFurman449
Henrietta Ayinor : Topic 1 DQ 1
Spirituality in my worldview has a great connection with faith, and a search for meaning and purpose in life, connection with others and surpassing Oneself. This results in s sense of inner peace and wellbeing. A strong spiritual connection may improve can improve an individual's sense of satisfaction with life or enable accommodation to disability (Delgado 2005)
Phenwan et al. (2019) Spirituality is the essence of a human being The meaning of life, feeling of connectedness to the transcendental phenomena such as the universe or God. This connectedness may or may not be part of any religions. It is also part of comprehensive palliative care, defined by the World Health Organization. An individual's spiritual well-being is a feeling of one's contentment that stems from their inner self and is related to their quality of life
SSorajjakool (2017) Religious beliefs and customs can significantly shape a nurse- patients relationship this can also influence the expectations of the nurse and patient as well as their wishes and personal boundaries regarding daily routines such as dressing, diet, prayer and touch. Undoubtedly, the sensitivity with which clinicians communicate with patients and make decisions regarding appropriate medical intervention can be greatly increased by an understanding of religious as well as other forms of cultural diversity. As a nurse caring for a patient will be deliberate in making effort to understand a patient's religious preferences this way, I will not impose my religious believes on the patient while helping them to access and receive preternatural care as a provide my nursing care this is beacuse different patienst have their spiritual prereferences and health and illness means dieferent things to dieferent people spiritually.
Delgado C. (2005). A discussion of the concept of spirituality. Nursing science quarterly, 18(2), 157–162. https://doi.org/10.1177/0894318405274828
https://pubmed.ncbi.nlm.nih.gov/15802748/
Phenwan, T., Peerawong, T., & Tulathamkij, K. (2019). The Meaning of Spirituality and Well- Being among Thai Breast Cancer Patients: A Qualitative Study. Indian journal of palliative care, 25(1), 119–123.
https://doi.org/10.4103/IJPC.IJPC_101_18
SSorajjakool, S., Carr, M. F., Nam, J. J., Sorajjakool, S., & Bursey, E. (Eds.). (2017). World religions for healthcare professionals. Taylor & Francis ISBN 1317281020, 9 781317281023
Retrievedfromhttps://www.routledge.com/World-Religions-for-Healthcare-Professionals/SSorajjakool-Carr-Nam-Sorajjakool-Carr-Bursey/p/book/9781138189140
Yenly Fernandez Rodriguez
1 posts
Re: Topic 1 DQ 1
Topic 1 DQ 1
Individuals hold different worldviews about spirituality. The spiritual worldview of an individual depends on various factors, such as family beliefs, origin, and culture. In the world, multiple religions exist to influence an individual's connection with a supreme being (SSorajjakool, Carr, Nam, Sorajjakool & Bursey, 2017). Fo ...
How religion and spirituality can help handoutauthors boards
A life-threatening disease, such as cancer, confronts us with realities and questions that prompts to step back from our lives and reflect on the meaning and implications of the illness. Our perspective on these realities and questions emerges in large measure from our religious, spiritual or philosophical orientation, and it influences how we experience the illness--its meaning, how we feel about it and how well we come to terms with it. A religious perspective can help us as we grapple with these issues and seek to keep our bearing through the mental and emotional turmoil that comes with having cancer.
In order to discuss how religion and spirituality can help in dealing with cancer, we want to first review some of the religious and spiritual issues, questions and problems that cancer presents. These are questions of meaning--the meaning of our life and what is important, the meaning behind our personal affliction with cancer and finding meaning in our suffering.
Death anxiety, religiosity and culture – future research directionsTutors India
Types of Death Anxieties
The fear of pain and the unknown, separation from loved ones and the irreversible end of existence after death cause death anxiety. Three types of death anxiety are listed here:
1) Predatory death anxiety is triggered by external situations that may be physically or psychologically dangerous, and anxiety ensures the organism’s survival in the face of adversity;
2) Predator death anxiety is triggered by an individual harming someone either physically or mentally and is often accompanied by unconscious guilt that may compel an individual to punish oneself; and
3) Existential death anxiety is triggered by an individual harming someone either physically or mentally.
A Review of The Healing Power of Faith: Science Explores Medicine’s Last Grea...David Grinstead, MA
Science is often perceived to be an opponent of religion/spirituality and likewise religion/spirituality is often perceived to be an opponent of science. There is a war of thought and faith that has been going on for centuries. Can these opposing world views be united?
Spirituality fulfills specific needs:
Meaning to life, illness, crises, and death
Sense of security for present and future
Guides daily habits
Elicits acceptance or rejection of other people
Provides psychosocial support in a group of like-minded people
Strength when facing life’s crises
Healing strength and support
(No Plagiarism) Explain the statement Although many leading organi.docxtamicawaysmith
(No Plagiarism) Explain the statement: "Although many leading organizations have invested significant resources in developing the culture and routines for this innovation processes, most organizations continue to rely on the efforts of a handful of people and chance. An innovative organization is one that can perfect these routines in addition to creating an innovation culture in the organization that engages people. Five key routines can facilitate its management of the innovation process” (Dooley & O'Sullivan, 2003).
.
What made you choose this career path What advice do you hav.docxtamicawaysmith
What made you choose this career path?
What advice do you have for those hoping to enter this career path?
What were some obstacles you faced upon graduating from college?
Does your career require graduate school? What programs would be acceptable?
Is there anything you wish you would have done differently?
Is it difficult to find a job in this area?
What is a typical work week like?
Etcetera, depending on the field and what you’re interested in.
.
Patient Population The student will describe the patient populati.docxtamicawaysmith
Patient Population: The student will describe the patient population that is impacted by the clinical issue. With a focus on the diversity of the human condition found within this patient population, the student will describe the influence that cultural values may have on the proposed solution. Proposed
Solution
: The student will set the stage for proposing the best solution to the clinical problem by using appropriate evidence-based data and integrating data from peer-reviewed journal articles. In this paper, the student will: i. Propose a clear solution to the clinical problem that is supported by a minimum of three scholarly, peer-reviewed journal articles.ii. Expand on the ethical considerations when developing the plan.
.
Dr. Paul Murray Bessie Coleman Jean-Bapiste Bell.docxtamicawaysmith
Dr. Paul Murray
Bessie Coleman
Jean-Bapiste Belley
Harriet Elizabeth Brown
Monte Irvin
Shirley Graham Dubois
Vernon Dahmer
Hale Woodruff
Jo Ann Robinson
Eugene "Pineapple" Jackson
Dr. Francis Cress Welsing
Dr. Kenneth Clark
Amy Jacques Garvey
Ophelia DeVore
Augusta Fells Savage
Eugene Jacques Bullard
Bobby Timmons
Clyde Kennard
Madison Washington
Joseph Winters
Sam Sharpe
Joseph Rainey
Bessie Stringfield
DJ Kool Herc
Lonnie Clayton
Mrs. Mamie Lang Kirkland
Lucius Septimius Bassianus
Carolyn Gudger
Jasmine Twitty
Daisy Bates
Ella Jenkins
Lewis Henry Douglass
Cynthia Robinson
Sylvester Magee
Mabel Fairbanks
Cathay Williams
Clara Belle Williams
John Baxter Taylor Jr.
Anna J. Cooper
The Black Seminoles
Dr. Daniel Hale Williams
Matthew Williams
Phillipa Schuyler
Yarrow Mamout
Mamie "Peanut" Johnson
Frank E. Petersen
"Miss Maggie" Walker
Paul Robeson
Olivia J. Hooker
Dr. Henry T Sampson
Lovie Yancy
Willie James Howard
Toni Stone (Marcenia Lyle Alberga)
Lucien Victor Alexis
Mevinia Sheilds
Dr. Lonnie Smith
Rosewood
Miss Jane Pittman
Lucy Terry
Abraham Galloway
Thomas Jennings
Irene Morgan
Paul Lawrence Dunbar
Jean Toomer
Doris Payne
Ann Petry
Madam C.J. Walker
Dr. May Edward Chinn
Greenwood, Tulsa, OK
Karen Bass
Dr. Dorothy Height
Dr. Geneva Smitherman
Michaëlle Jean
Robin Kelly
Mary Macleod Bethune
Jane Bolin
Donna Edwards
Dame Eugenia Charles
Dr. Thomas Elkins
Wilma Rudolph
Annie Malone
Ann Lowe
Black Wall Street
Cathy Hughes
Kamala Harris
Fannie Lou Hamer
Sarah Rector
Ruth Simmons
Claudette Colvin
MC Lyte
Benajin Banneker
Benjamin O. Davis, Jr.
Thurgood Marshall
Doris "Dorie" Miller
Cecil Noble
WC Handy
Dorothy Counts
Bayard Rustin
Dr. Eliza Ann Grier
Matthew Henson
Jesse Owens
Nina Simone
Wendell Scott
Adam Clayton Powell
Percy Julian
Dr. Charles Drew
Thomas "Fats" Waller
Satchel Paige
Bass Reeves
Marian Anderson
Josephine Baker
Joe Louis
Walter White
William Hastie
Elijah McCoy
Jan Matzelger
Lewis Latimer
Granville T. Woods
Fred Jones
Nella Larsen
Lloyd Hall
A. Philip Randolph
Althea Gibson
Barbara C. Jordon
Marcus Garvey
Malcolm X
James Meridith
Guy Buford
Hazel Scott
Stokely Carmichal
Denmark Vessey
Alex Haley
Virginia Hamilton
Ishmael Reed
Nalo Hopkinson
George Schuyler
Patricia Roberts Harris
John Lewis
Les McCann
Martin Delany
Derek Walcott
Carter Godwin Woodson
Alvin Ailey
Debbie Allen
Ralph Abernathy
Arthur Ashe
Crispus Attucks
Amiri Baraka
Seko.
In depth analysis of your physical fitness progress Term p.docxtamicawaysmith
In depth analysis of your physical fitness progress
Term paper should include details of:
▪ What worked and why (include all documentation)
▪ What didn’t and why
▪ Are your physical fitness results in alignment with your health continuum goals (include documentation)
▪ What are your current goals
▪ What are your future goals
▪ Develop a road map to get achieve those goals Due no later than November 30, 2020.
samples
Physical fitness benchmark assessments
Fitness assessment data sheet
Exercise charts
Personal physical fitness progress chart
Self assessment: Individual Health Continuum
.
Information systems infrastructure evolution and trends Str.docxtamicawaysmith
Information systems infrastructure: evolution and trends
Strategic importance of cloud computing in business organizations
Big data and its business impacts
Managerial issues of a networked organization
Emerging enterprise network applications
Mobile computing and its business implications
Instructions:
9- 10 pages (does not include Title page and references )
can Include images (not more than two)
Minimum six (6) sources – at least two (2) from peer reviewed journals
Include an abstract, introduction, and conclusion
.
⦁One to two paragraph brief summary of the book. ⦁Who is the.docxtamicawaysmith
⦁One to two paragraph brief summary of the book.
⦁Who is the author and his/her background?
⦁Does the author have any particular ideological viewpoint that he or she is trying to advance or do you consider the author to have been neutral and presented both sides of controversial issues? (You will find asking this same question will help you in other courses and your future career.)
⦁When was this book written? Does the author reflect the views (biases) of the time when the book was written? Why or why not?
⦁What did you find most interesting in the book? Least interesting?
⦁What additional topics should the author have included in the book? Why?
⦁How had people before the age of the telegraph attempted to communicate faster over distances?
⦁How did the telegraph reflect scientific and technological developments, both in the United States and other countries?
⦁Why did the telegraph represent such a revolutionary development and not just an incremental improvement in communication?
⦁How did the telegraph impact politics, journalism, business, military strategy and society in general?
⦁How were the American and European experiences similar or different in developing the telegraph? Did the telegraph have a similar impact in the United States and Europe?
⦁What do you think of the author’s title? Is the Victorian-era telegraph really the equivalent of today’s internet in terms of its impact or is that an exaggeration? Why or why not?
⦁Do you think the author makes the material interesting, understandable and relevant to the general public? Why or why not?
⦁If you were the editor in the publishing company, what changes would you make to the author’s draft?
⦁Did the book increase your interest in a particular issue that you would like to learn more about?
⦁Do you think it is worthwhile learn about the historical impact of scientific and technological developments?
⦁Would you recommend this book to a friend? Why or why not?
⦁Would you recommend that I continue to use this book in this course with future students?
.
Henrietta Ayinor Topic 1 DQ 1Spirituality in my worldview has SusanaFurman449
Henrietta Ayinor : Topic 1 DQ 1
Spirituality in my worldview has a great connection with faith, and a search for meaning and purpose in life, connection with others and surpassing Oneself. This results in s sense of inner peace and wellbeing. A strong spiritual connection may improve can improve an individual's sense of satisfaction with life or enable accommodation to disability (Delgado 2005)
Phenwan et al. (2019) Spirituality is the essence of a human being The meaning of life, feeling of connectedness to the transcendental phenomena such as the universe or God. This connectedness may or may not be part of any religions. It is also part of comprehensive palliative care, defined by the World Health Organization. An individual's spiritual well-being is a feeling of one's contentment that stems from their inner self and is related to their quality of life
SSorajjakool (2017) Religious beliefs and customs can significantly shape a nurse- patients relationship this can also influence the expectations of the nurse and patient as well as their wishes and personal boundaries regarding daily routines such as dressing, diet, prayer and touch. Undoubtedly, the sensitivity with which clinicians communicate with patients and make decisions regarding appropriate medical intervention can be greatly increased by an understanding of religious as well as other forms of cultural diversity. As a nurse caring for a patient will be deliberate in making effort to understand a patient's religious preferences this way, I will not impose my religious believes on the patient while helping them to access and receive preternatural care as a provide my nursing care this is beacuse different patienst have their spiritual prereferences and health and illness means dieferent things to dieferent people spiritually.
Delgado C. (2005). A discussion of the concept of spirituality. Nursing science quarterly, 18(2), 157–162. https://doi.org/10.1177/0894318405274828
https://pubmed.ncbi.nlm.nih.gov/15802748/
Phenwan, T., Peerawong, T., & Tulathamkij, K. (2019). The Meaning of Spirituality and Well- Being among Thai Breast Cancer Patients: A Qualitative Study. Indian journal of palliative care, 25(1), 119–123.
https://doi.org/10.4103/IJPC.IJPC_101_18
SSorajjakool, S., Carr, M. F., Nam, J. J., Sorajjakool, S., & Bursey, E. (Eds.). (2017). World religions for healthcare professionals. Taylor & Francis ISBN 1317281020, 9 781317281023
Retrievedfromhttps://www.routledge.com/World-Religions-for-Healthcare-Professionals/SSorajjakool-Carr-Nam-Sorajjakool-Carr-Bursey/p/book/9781138189140
Yenly Fernandez Rodriguez
1 posts
Re: Topic 1 DQ 1
Topic 1 DQ 1
Individuals hold different worldviews about spirituality. The spiritual worldview of an individual depends on various factors, such as family beliefs, origin, and culture. In the world, multiple religions exist to influence an individual's connection with a supreme being (SSorajjakool, Carr, Nam, Sorajjakool & Bursey, 2017). Fo ...
How religion and spirituality can help handoutauthors boards
A life-threatening disease, such as cancer, confronts us with realities and questions that prompts to step back from our lives and reflect on the meaning and implications of the illness. Our perspective on these realities and questions emerges in large measure from our religious, spiritual or philosophical orientation, and it influences how we experience the illness--its meaning, how we feel about it and how well we come to terms with it. A religious perspective can help us as we grapple with these issues and seek to keep our bearing through the mental and emotional turmoil that comes with having cancer.
In order to discuss how religion and spirituality can help in dealing with cancer, we want to first review some of the religious and spiritual issues, questions and problems that cancer presents. These are questions of meaning--the meaning of our life and what is important, the meaning behind our personal affliction with cancer and finding meaning in our suffering.
Death anxiety, religiosity and culture – future research directionsTutors India
Types of Death Anxieties
The fear of pain and the unknown, separation from loved ones and the irreversible end of existence after death cause death anxiety. Three types of death anxiety are listed here:
1) Predatory death anxiety is triggered by external situations that may be physically or psychologically dangerous, and anxiety ensures the organism’s survival in the face of adversity;
2) Predator death anxiety is triggered by an individual harming someone either physically or mentally and is often accompanied by unconscious guilt that may compel an individual to punish oneself; and
3) Existential death anxiety is triggered by an individual harming someone either physically or mentally.
A Review of The Healing Power of Faith: Science Explores Medicine’s Last Grea...David Grinstead, MA
Science is often perceived to be an opponent of religion/spirituality and likewise religion/spirituality is often perceived to be an opponent of science. There is a war of thought and faith that has been going on for centuries. Can these opposing world views be united?
Spirituality fulfills specific needs:
Meaning to life, illness, crises, and death
Sense of security for present and future
Guides daily habits
Elicits acceptance or rejection of other people
Provides psychosocial support in a group of like-minded people
Strength when facing life’s crises
Healing strength and support
Similar to 352 BUMC PROCEEDINGS 2001;14352–357The technological adva.docx (14)
(No Plagiarism) Explain the statement Although many leading organi.docxtamicawaysmith
(No Plagiarism) Explain the statement: "Although many leading organizations have invested significant resources in developing the culture and routines for this innovation processes, most organizations continue to rely on the efforts of a handful of people and chance. An innovative organization is one that can perfect these routines in addition to creating an innovation culture in the organization that engages people. Five key routines can facilitate its management of the innovation process” (Dooley & O'Sullivan, 2003).
.
What made you choose this career path What advice do you hav.docxtamicawaysmith
What made you choose this career path?
What advice do you have for those hoping to enter this career path?
What were some obstacles you faced upon graduating from college?
Does your career require graduate school? What programs would be acceptable?
Is there anything you wish you would have done differently?
Is it difficult to find a job in this area?
What is a typical work week like?
Etcetera, depending on the field and what you’re interested in.
.
Patient Population The student will describe the patient populati.docxtamicawaysmith
Patient Population: The student will describe the patient population that is impacted by the clinical issue. With a focus on the diversity of the human condition found within this patient population, the student will describe the influence that cultural values may have on the proposed solution. Proposed
Solution
: The student will set the stage for proposing the best solution to the clinical problem by using appropriate evidence-based data and integrating data from peer-reviewed journal articles. In this paper, the student will: i. Propose a clear solution to the clinical problem that is supported by a minimum of three scholarly, peer-reviewed journal articles.ii. Expand on the ethical considerations when developing the plan.
.
Dr. Paul Murray Bessie Coleman Jean-Bapiste Bell.docxtamicawaysmith
Dr. Paul Murray
Bessie Coleman
Jean-Bapiste Belley
Harriet Elizabeth Brown
Monte Irvin
Shirley Graham Dubois
Vernon Dahmer
Hale Woodruff
Jo Ann Robinson
Eugene "Pineapple" Jackson
Dr. Francis Cress Welsing
Dr. Kenneth Clark
Amy Jacques Garvey
Ophelia DeVore
Augusta Fells Savage
Eugene Jacques Bullard
Bobby Timmons
Clyde Kennard
Madison Washington
Joseph Winters
Sam Sharpe
Joseph Rainey
Bessie Stringfield
DJ Kool Herc
Lonnie Clayton
Mrs. Mamie Lang Kirkland
Lucius Septimius Bassianus
Carolyn Gudger
Jasmine Twitty
Daisy Bates
Ella Jenkins
Lewis Henry Douglass
Cynthia Robinson
Sylvester Magee
Mabel Fairbanks
Cathay Williams
Clara Belle Williams
John Baxter Taylor Jr.
Anna J. Cooper
The Black Seminoles
Dr. Daniel Hale Williams
Matthew Williams
Phillipa Schuyler
Yarrow Mamout
Mamie "Peanut" Johnson
Frank E. Petersen
"Miss Maggie" Walker
Paul Robeson
Olivia J. Hooker
Dr. Henry T Sampson
Lovie Yancy
Willie James Howard
Toni Stone (Marcenia Lyle Alberga)
Lucien Victor Alexis
Mevinia Sheilds
Dr. Lonnie Smith
Rosewood
Miss Jane Pittman
Lucy Terry
Abraham Galloway
Thomas Jennings
Irene Morgan
Paul Lawrence Dunbar
Jean Toomer
Doris Payne
Ann Petry
Madam C.J. Walker
Dr. May Edward Chinn
Greenwood, Tulsa, OK
Karen Bass
Dr. Dorothy Height
Dr. Geneva Smitherman
Michaëlle Jean
Robin Kelly
Mary Macleod Bethune
Jane Bolin
Donna Edwards
Dame Eugenia Charles
Dr. Thomas Elkins
Wilma Rudolph
Annie Malone
Ann Lowe
Black Wall Street
Cathy Hughes
Kamala Harris
Fannie Lou Hamer
Sarah Rector
Ruth Simmons
Claudette Colvin
MC Lyte
Benajin Banneker
Benjamin O. Davis, Jr.
Thurgood Marshall
Doris "Dorie" Miller
Cecil Noble
WC Handy
Dorothy Counts
Bayard Rustin
Dr. Eliza Ann Grier
Matthew Henson
Jesse Owens
Nina Simone
Wendell Scott
Adam Clayton Powell
Percy Julian
Dr. Charles Drew
Thomas "Fats" Waller
Satchel Paige
Bass Reeves
Marian Anderson
Josephine Baker
Joe Louis
Walter White
William Hastie
Elijah McCoy
Jan Matzelger
Lewis Latimer
Granville T. Woods
Fred Jones
Nella Larsen
Lloyd Hall
A. Philip Randolph
Althea Gibson
Barbara C. Jordon
Marcus Garvey
Malcolm X
James Meridith
Guy Buford
Hazel Scott
Stokely Carmichal
Denmark Vessey
Alex Haley
Virginia Hamilton
Ishmael Reed
Nalo Hopkinson
George Schuyler
Patricia Roberts Harris
John Lewis
Les McCann
Martin Delany
Derek Walcott
Carter Godwin Woodson
Alvin Ailey
Debbie Allen
Ralph Abernathy
Arthur Ashe
Crispus Attucks
Amiri Baraka
Seko.
In depth analysis of your physical fitness progress Term p.docxtamicawaysmith
In depth analysis of your physical fitness progress
Term paper should include details of:
▪ What worked and why (include all documentation)
▪ What didn’t and why
▪ Are your physical fitness results in alignment with your health continuum goals (include documentation)
▪ What are your current goals
▪ What are your future goals
▪ Develop a road map to get achieve those goals Due no later than November 30, 2020.
samples
Physical fitness benchmark assessments
Fitness assessment data sheet
Exercise charts
Personal physical fitness progress chart
Self assessment: Individual Health Continuum
.
Information systems infrastructure evolution and trends Str.docxtamicawaysmith
Information systems infrastructure: evolution and trends
Strategic importance of cloud computing in business organizations
Big data and its business impacts
Managerial issues of a networked organization
Emerging enterprise network applications
Mobile computing and its business implications
Instructions:
9- 10 pages (does not include Title page and references )
can Include images (not more than two)
Minimum six (6) sources – at least two (2) from peer reviewed journals
Include an abstract, introduction, and conclusion
.
⦁One to two paragraph brief summary of the book. ⦁Who is the.docxtamicawaysmith
⦁One to two paragraph brief summary of the book.
⦁Who is the author and his/her background?
⦁Does the author have any particular ideological viewpoint that he or she is trying to advance or do you consider the author to have been neutral and presented both sides of controversial issues? (You will find asking this same question will help you in other courses and your future career.)
⦁When was this book written? Does the author reflect the views (biases) of the time when the book was written? Why or why not?
⦁What did you find most interesting in the book? Least interesting?
⦁What additional topics should the author have included in the book? Why?
⦁How had people before the age of the telegraph attempted to communicate faster over distances?
⦁How did the telegraph reflect scientific and technological developments, both in the United States and other countries?
⦁Why did the telegraph represent such a revolutionary development and not just an incremental improvement in communication?
⦁How did the telegraph impact politics, journalism, business, military strategy and society in general?
⦁How were the American and European experiences similar or different in developing the telegraph? Did the telegraph have a similar impact in the United States and Europe?
⦁What do you think of the author’s title? Is the Victorian-era telegraph really the equivalent of today’s internet in terms of its impact or is that an exaggeration? Why or why not?
⦁Do you think the author makes the material interesting, understandable and relevant to the general public? Why or why not?
⦁If you were the editor in the publishing company, what changes would you make to the author’s draft?
⦁Did the book increase your interest in a particular issue that you would like to learn more about?
⦁Do you think it is worthwhile learn about the historical impact of scientific and technological developments?
⦁Would you recommend this book to a friend? Why or why not?
⦁Would you recommend that I continue to use this book in this course with future students?
.
100.0 Criteria10.0 Part 1 PLAAFP The PLAAFP thoroughly an.docxtamicawaysmith
100.0 %Criteria
10.0 %Part 1: PLAAFP
The PLAAFP thoroughly and adeptly incorporates student's academic strengths, evaluations, performance in classes, and any other relevant issues.
10.0 %Part 2: Present Levels for Transition COE 3.8 [CEC 5.1, ICSI.5.S8, ICSI.5.S15, IGC.5.K1, IGC.5.S7, IGC.5.S23, IGC.5.S24; InTASC 1(b), 2(d), 5(f), 6(v), 8(s), 9(h); MC2, MC3, MC4, MC5]
Preferential learning environment, strengths and interests relating to the transition, and areas in need of improvement for transition are substantially described.
15.0 %Part 2: Transition Plan COE: 3.10 [CEC 5.5, ICSI.5.S8, ICSI.5.S8, ICSI.5.S15, ICSI.5.S17, ICSI.5.S19, IGC.5.K1, IGC.5.K3, IGC.5.K8, IGC.5.S1, IGC.5.S2, IGC.5.S11 IGC.5.S23, IGC.5.S24; InTASC 7(b), 7(e); MC1, MC2, MC4, MC5]
The transition plan demonstrates best practices in identifying proficient, measureable transition plan goals that are aligned with student's interests and present levels. Also includes quality aligned activities/services, persons/agency involved and realistic expected dates of achievement.
10.0 %Part 3: Rationale - Justification COE: 5.1 [ACEI 5.0; CEC 6.1, ICSI.6.K2, ICSI.6.K4 ICSI.6.S1, ICSI.6.S2, ICSI.6.S3, ICSI.6.S4, ICSI.6.S5, ICSI.6.S7, IGC.6.K4, IGC.6.K6, IGC.6.S2; InTASC 9(l), 9(o); MC2, MC3, MC4]
Rationale skillfully justifies content and decisions displayed in PLAAFP, annual goals, and transition plan, convincingly demonstrating how they meet the needs of the student. Claims are fully grounded in CEC Code of Ethics.
15.0 %Part 4: Rationale - Confidentiality COE: 5.8 [CEC 6.1, ICSI.6.S1, ICSI.6.S2, ICSI.6.S4, ICSI.7.S1, IGC.6.K1, IGC.6.K6; InTASC 5(k); MC1, MC2, MC4, MC5]
The rationale thoroughly defends the legal, ethical, and quality requirements related to the management of confidential student information.
10.0 %Reflection COE: 5.4 [CEC 6.2, ICSI.6.S1, ICSI.6.S2, ICSI.6.S4, IGC.6.K1, IGC.6.K2, IGC.6.K3; InTASC 10(h); MC1, MC2, MC4; COE 5.4]
Reflection convincingly relates how foundational knowledge developed relating to providing professional, ethical and legal educational services will be used in future professional practice.
5.0 %Research
Research strongly supports the information presented. Sources are timely, distinctive and clearly address all of the criteria stated in the assignment.
10.0 %Organization
The content is well-organized and logical. There is a sequential progression of ideas that relate to each other. The content is presented as a cohesive unit and provides the audience with a clear sense of the main idea.
10.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)
Submission is virtually free of mechanical errors. Word choice reflects well-developed use of practice and content-related language. Sentence structures are varied and engaging.
5.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
Sources are documented completely and correctly, as appropria.
102120151De-Myth-tifying Grading in Sp.docxtamicawaysmith
10/21/2015
1
De-Myth-tifying Grading
in Special Education
1980 2015
10/21/2015
2
Primary Purpose
• “the primary purpose of…grades…
(is) to communicate student
achievement to students, parents,
school administrators,
post-secondary institutions and
employers.” and
• To provide teachers with information
for instructional planning.
Taken from “Reporting Achievement at the Secondary School Level: What and How?”, in Communicating Student
Learning: ASCD Yearbook 1996, p. 120.
What makes grading so
hard?
• Teacher preparation programs seldom include course work or
even discussions of recommended practices for grading
students in general, much less for students who may be
struggling learners. As a result, teachers at all grade levels
grapple with issues of fairness in grading.
• Despite the magnitude of this problem, few recommendations
for grading struggling learners can be found in the research
literature or in education policy.
• Urban Grading Legends
10/21/2015
3
Urban Legends:
Bigfoot/Sasquatch
Urban Legends
• I can’t fail a special education
student.
• I give all my Life Skills students an
85.
• The report card grade does not really
mean anything.
10/21/2015
4
Urban Legends
• The grade on the report card can’t be less
than the IEP mastery level (default 70%)
• I teach a lot in my classroom, but I can
only grade the things that are on the IEP.
• I don’t do the grades for my special
education students in my classroom, the
special education teacher does that for
me.
What’s the
problem??
• Some students are not getting REAL
grades.
• Multiple court cases regarding failing
students who are not receiving
appropriate specially designed instruction
or students only get “A’s” and it doesn’t
truly reflect how he/she really performs in
relation to the curriculum
10/21/2015
5
What does the law really
say?
• Neither the Individuals with Disabilities Education Act
(IDEA) nor any other federal education laws contain
requirements for grading. Therefore, each state has
discretion on the issue.
• The TEC is the set of state laws our state legislators have
passed that relate to education. ARD committees do not
have the authority to override state laws. The Texas
Administrative Code (TAC) is the set of rules that the State
Legislature has authorized Texas Education Agency (TEA)
or the State Board to write. ARD committees must also
follow these rules.
• The state statutes apply to all public school students in
Texas regardless of special education eligibility.
Local Grading Policies
TEC §28.0216
(1) “must require a classroom teacher to assign a grade that
reflects the students’ relative mastery of an assignment;
[and]
(2) may not require a classroom teacher to assign a
minimum grade for an assignment without regard to the
student’s quality of work.”
(3) may allow a student a reasonable opportunity to make up
or redo a class .
100.0 %Criteria
30.0 %Flowchart Content
The flowchart skillfully depicts the two possible discipline paths following the manifestation determination. In addition, there are two comprehensively aligned IEP goals for each determination.
40.0 %Legal Issues Analysis
A compelling analysis is included regarding any legal issues raised by the change in Carrie's transportation, proficiently incorporating relevant statutes, regulations, and case decisions.
5.0 %Research
Research strongly supports the information presented. Sources are timely, distinctive and clearly address all of the criteria stated in the assignment.
5.0 %Rationale Organization
The content is well organized and logical. There is a sequential progression of ideas related to each other. The content is presented as a cohesive unit and the audience is provided with a clear sense of the main idea.
5.0 %Overall Flowchart Presentation
The work is well presented. The overall appearance is neat and professional. Work would be highly desirable for public dissemination.
10.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)
Submission is virtually free of mechanical errors. Word choice reflects well-developed use of practice and content-related language. Sentence structures are varied and engaging.
5.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
Sources are documented completely and correctly, as appropriate to assignment and style, and format is free of error.
100 %Total Weightage
.
100 words agree or disagree to eac questions Q 1.As her .docxtamicawaysmith
100 words agree or disagree to eac questions
Q 1.
As her defense attorney, I will argue that the officer did not only not read Sally's Miranda rights; he also did not respect her right to consul. After Sally made her allegedly verbal utterance, the Officer should have known to read Sally her rights. I will bring up that during New Jersey v. James P. Kucinski, Oct 26, 2016, the defendant was arrested for the bludgeoning death of his brother. The defendant was taken to police headquarters for questioning after the defendant was advised of his Miranda rights; he requested an attorney. The law enforcement officers terminated the interrogation, spoked with their supervisor, and approximately eight minutes later, the officers returned into the room and advised the defendant that he was being charged with murder. The scare tactic worked, and the defendant asked to speak with the officers. The defendant reluctantly answered a series of questions. Before trial, the defendant moved for suppression motion because the officers did not honor his request for counsel. The court denied the motion, during further questioning the defendant claimed to have acted in self-defense, the defense counsel moved for a mistrial. The trial court denied the motion for mistrial but instructed the jury that the defendant's right to remain silent should be limited to assessing his credibility. The defendant was charged with first-degree murder and third-degree possession of a weapon for unlawful purposes The Appellate Division reversed the defendant's conviction and motion for a new trial due to the prosecutor's question doing cross-examination was improper. The panel concluded that the defendant invoked his right to remain silent by telling law enforcement officers that he did not want to talk or answer questions. The Appellate Division found that the trial court instructions to the jury were flaws, and the supreme court agreed and affirmed. The officers should have stopped all questioning and contacted the defendant's attorney.
New Jersey v. Kucinski (2017). https://law.justia.com/cases/new-jersey/supreme-court/2017/a-58-15.html
Q 2.
My last name begins with a K. so I am answering in the role of prosecutor. Sally was originally pulled over because she had shown probable cause of drunk driving. Upon her traffic stop, Sally was then searched after being arrested and the handgun and drugs were found on her body. The police asked about the two items but did not “interrogate” her. Sally voluntarily answered the arresting officers’ questions and in doing so piled new charges onto her initial arrest charge. I believe that the judge will deny the request to suppress the admission of Sally’s statements. Sally does have rights under the Fifth Amendment, but her statements to the police officers were not coerced out of her. The Cornell Law School website states that the Fifth Amendment, under the self-incrimination clause, if an individual makes a spo.
101118, 4(36 PMCollection – MSA 603 Strategic Planning for t.docxtamicawaysmith
10/11/18, 4(36 PMCollection – MSA 603 Strategic Planning for the Admin ...
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reading. A Collection must be created to tag posts. More Help
Thread: dis 4
Post: dis 4
Author:
Posted Date: October 9, 2018 8:50 PM
Status: Published
Overall Rating:
Tags: None
(Post is Read)
Brian Mcleod
I would say that for them to move the work and still be ethical defensible are work conditions,
respect for labor laws of the parent company, and job opportunities for the long-term
employees.
To expand on this would be the work conditions. The conditions that the workers have to work
under should be the same conditions that workers in the US have to work under. This involves
safety and environmental protection for the workers.
Labor laws of the host country and “most” of the internally recognized laws must be observed.
Overtime and child labor are a couple of items.
The long-term employees should be given the opportunity to move to another US based plant if
possible or to the new country.
Sometimes because of the state of the industry companies do have to make these decisions or
face possible bankruptcy. This alternative may not be the perfect solution but better than
bankrupting a company that still has operation in the US.
← OK
�
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Thread: DB4
Post: DB4
Author:
Posted Date: October 10, 2018 8:51 PM
Status: Published
Overall Rating:
Tags: None
(Post is Read)
Christina Lacroix
It is ethically defensible to outsource production when the outcome of not outsourcing
would negatively impact stakeholders. Organizations define their most important
stakeholders, often the shareholders, as they invested capital. While some risk is
assumed by shareholders as a fiduciary managers have an obligation to the
shareholders to protect their interest when possible. A company risks shareholder
investment (access to capital) and jeopardizes all other stakeholders such as
employees, suppliers, and creditors. An organization cannot risk itself and the other
stakeholders depending upon in order to save employees.
The organization should do its due diligence in securing its outso.
100 words per question, no references needed or quotations. Only a g.docxtamicawaysmith
100 words per question, no references needed or quotations. Only a general idea or opinion.
A.
· Compare and contrast two works from the Italian Baroque period with two works from the Renaissance. Be sure to note the appearance in the works of the defining characteristics from each period.
· Discuss why artistic expression shifted from the restrained stoicism of the Renaissance to that of the heightened emotion in the religious and other works of the Baroque.
B. From video
Goya -
The Third of May
- If you cannot see this video, click here -
https://youtu.be/e7piV4ocukg
Respond in writing to the following questions after reading Chapter 12, watching the video, and exploring the sites above.
1. Heroism, nationalism, and passion are themes associated with Romanticism. Which
three
landmarks of the nineteenth century are most representative of these themes? You can discuss art, philosophy, or literature.
2. Compare Neoclassicism and Romanticism as styles and sensibilities. What do their differences reflect about patronage, popular taste, and historical change? Provide specific examples from the chapters.
C.
1. From the arts of West Africa, what are some characteristics of African cultural heritage?
2. How did their religious beliefs influence their art and music.
D.
Watch video below
Manet -
Déjeuner
sur
l’herbe -
If you cannot see this video, click
https://youtu.be/3xBGF8H3bQ4
1. Viewers of Manet’s
Déjeuner sur l’herbe
initially responded to its public display by attacking the canvas with their umbrellas. Why?
2. What kind of art has evoked a comparable response in our own time? Do some research online. Find a recent work of art that caused controversy. Summarize the reasons for the controversy and your reaction to it. Try not post the same article as someone else. (This board is not POST FIRST, so you will be able to see what others have posted right away.) If you can, attach a picture of the image you are describing to your posting.
E.
Watch the video below. If you cannot see the video, click here:
https://youtu.be/XyLNPumMMTs
George Braque, Violin and Pitcher, (1909)
•
Pablo Picasso, Guernica, (1937)
•
Marcel Duchamp, Nude Descending a Staircase, (1912)
Respond in writing to the following question after reading Chapter 14 in your text, watching the video above, viewing the Web Assignments, and the sites above.
1. Describe how they three have departed from styles such as symbolism and impressionism of the late nineteenth century.
F.
Take some time to reflect on all we have covered in this course. Then, respond in writing to the following question.
1. After your experience in this course, describe why you feel the humanities are important.
.
100A 2
2 4 4
5
1A 1034 5
1B 1000 10
1C 1100 1
1D 1123 20
1E 1210 5
20 10 10
7
1A 2180 20
1B 1283 20
1C 3629 5
1D 3649 3
1E 4051 15
1F 4211 1
1G 5318 5
100B 1
2 4 1
3
1A 2180 10
1B 1283 10
1C 3629 5
100C 2
0 0 0
3
1A 6774 5
1B 6869 5
1C 6879 2
0 0 0
4
1A 6774 2
1B 6869 5
1C 6879 1
1D 7555 10
100D 1
10 5 3
3
1A 2180 5
1B 3649 2
1C 4211 3
Self-care and Residency Reflection Paper Scoring Rubric -
Content
80 Points
Points Earned
Additional Comments:
All key elements of the assignment are covered in a substantive way.
Write a 700- to 1,050-word paper to reflect on your residency experience and outline your plan for self-care. Please use the self-care and residency reflection paper template posted in Student Materials for this assignment.
Consider the following questions when writing your reflection:
a) What have you learned about yourself during residency?
b) What have you learned about yourself as a counselor-in-training during residency?
c) What are aspects of residency that you enjoyed? Why did you enjoy these aspects?
d) What aspects of residency did you not enjoy? Why did you not enjoy these aspects?
e) What is counselor self-care? Why is it important? Include two separate in-text and end of work references.
f) What strategies for maintaining self-care did you try throughout this program? How can you implement these strategies?
g) How will you know when you are experiencing burnout? What can you do to prevent this?
The content is comprehensive, accurate, and /or persuasive.
The paper links theory to relevant examples of current experience and industry practice and uses the vocabulary of the theory correctly. This refers to the use of literary references. Generally you will need one separate literary reference for each main point (objective) of your paper.
Major points are stated clearly and are supported by specific details, examples, or analysis.
Organization / Development
35 Points
Points Earned
Additional Comments:
The paper has a structure that is clear, logical, and easy to follow.
The paper develops a central theme or idea, directed toward the appropriate audience.
The introduction provides sufficient background on the topic and previews major points.
The conclusion is logical, flows from the body of the paper, and reviews the major points.
Transitions between sentences/ paragraphs/sections aid in maintaining the flow of thought.
The tone is appropriate to the content and assignment.
Mechanics
35 Points
Points Earned
Additional Comments:
The paper, including the title page, reference page, tables, and appendices follow APA guidelines for format.
Citations of original works within the body of the paper follow APA guidelines.
The paper is laid out with effective use of headings, font styles, and white space.
Rules of grammar, usage, and punctuation are followed.
Sentences are complete, clear, concise, and varied.
Spelling is correct.
.
10122018Week 5 Required Reading and Supplementary Materials - .docxtamicawaysmith
10/12/2018
Week 5 Required Reading and Supplementary Materials - MGMT 670 9042 Strategic Management Capstone (2188)
https://learn.umuc.edu/d2l/le/content/333174/viewContent/13406413/View
/2
Required Readings:
From the UMUC library: (Note: You must search for these articles in the UMUC library. In the case of video links in the UMUC library, exact directions are given on how to find the video.)
Porter's Five-Forces model. (2009). In Encyclopedia of management (6th Ed., pp. 714-717).
From Other websites:
Evaluating the industry. (2012). In Mastering strategic management. Washington, DC: Saylor Academy. Retrieved from https://saylordotorg.github.io/text_mastering-strategic-management/s07-03-evaluating-the-industry.html
The impact of external and internal factors on strategy. (2016, 31 May). In Boundless Management. Retrieved from https://courses.lumenlearning.com/boundless-management/chapter/strategic-management/
Mapping strategic groups. (2012). In Mastering strategic management. Washington, DC: Saylor Academy. Retrieved from https://saylordotorg.github.io/text_mastering-strategic-management/s07-04-mapping-strategic-groups.html
The PESTEL and SCP frameworks. (2016, 26 May). In Boundless management. Retrieved from https://courses.lumenlearning.com/boundless-management/chapter/external-inputs-to-strategy/
The relationship between an organization and its environment. (2012). In Mastering strategic management. Washington, DC: Saylor Academy. Retrieved from https://saylordotorg.github.io/text_mastering-strategic-management/s07-01-the-relationship-between-an- or.html
Strategic group mapping. (2010, October 5). MBA lectures. Retrieved from http://mba-lectures.com/management/strategic- management/1000/strategic-group-mapping.html
Supplementary Materials:
From the UMUC library: (Note: You must search for these articles in the UMUC library. In the case of video links in the UMUC library, exact directions are given on how to find the video.)
Anand, B. N. (2006). Crafting business strategy and environmental scanning [Video]. Harvard Business School Faculty Seminar Series.
Follow these steps to find this video:
Go to http://sites.umuc.edu/library/index.cfm
Type in the entire name of the article: "Crafting business strategy and environmental scanning," into the search box and click on "search."
Click on "multimedia" in the upper left hand corner of the webpage (under "Ask a Librarian.)
Type in the entire name of the article: "Crafting business strategy and environmental scanning," in the box at the top of the page to the left of the word, "Search."
Make sure only "Business Videos" and "Find all my search term" are the only boxes that are checked. Uncheck both "Image Collection" and "Apply equivalent
subjects"
Click on "Search" at the bottom right hand corner of the webpage. It is a small word in a box. The next page shows the article. Click on the article.
Dahab, S. (2008). Five forces. In S. R. Clegg & J. R. Bailey (Eds.), International en.
101416 526 PMAfter September 11 Our State of Exception by .docxtamicawaysmith
10/14/16 5:26 PMAfter September 11: Our State of Exception by Mark Danner | The New York Review of Books
Page 1 of 11http://www.nybooks.com/articles/2011/10/13/after-september-11-our-state-exception/?printpage=true
After September 11: Our State of Exception
Mark Danner OCTOBER 13, 2011 ISSUE
We are in a fight for our principles, and our first responsibility is to live by them.
—George W. Bush, September 20, 2001
1.
We are living in the State of Exception. We don’t know when it will end, as we don’t know when the War on Terror will
end. But we all know when it began. We can no longer quite “remember” that moment, for the images have long since
been refitted into a present-day fable of innocence and apocalypse: the perfect blue of that late summer sky stained by acrid
black smoke. The jetliner appearing, tilting, then disappearing into the skin of the second tower, to emerge on the other
side as a great eruption of red and yellow flame. The showers of debris, the falling bodies, and then that great blossoming
flower of white dust, roiling and churning upward, enveloping and consuming the mighty skyscraper as it collapses into the
whirlwind.
To Americans, those terrible moments stand as a brightly lit portal through which we were all compelled to step, together,
into a different world. Since that day ten years ago we have lived in a subtly different country, and though we have grown
accustomed to these changes and think little of them now, certain words still appear often enough in the news—
Guantánamo, indefinite detention, torture—to remind us that ours remains a strange America. The contours of this
strangeness are not unknown in our history—the country has lived through broadly similar periods, at least half a dozen or
so, depending on how you count; but we have no proper name for them. State of siege? Martial law? State of emergency?
None of these expressions, familiar as they may be to other peoples, falls naturally from American lips.
What are we to call this subtly altered America? Clinton Rossiter, the great American scholar of “crisis government,”
writing in the shadow of World War II, called such times “constitutional dictatorship.” Others, more recently, have spoken
of a “9/11 Constitution” or an “Emergency Constitution.” Vivid terms all; and yet perhaps too narrowly drawn, placing as
they do the definitional weight entirely on law when this state of ours seems to have as much, or more, to do with politics
—with how we live now and who we are as a polity. This is in part why I prefer “the state of exception,” an umbrella term
that gathers beneath it those emergency categories while emphasizing that this state has as its defining characteristic that it
transcends the borders of the strictly legal—that it occupies, in the words of the philosopher Giorgio Agamben, “a position
at the limit between politics and law…an ambiguous, uncertain, borderline fringe, at the intersection of the legal and the
political.”
Call it, then, the s.
100 words per question, no references needed or quotations. Only.docxtamicawaysmith
100 words per question, no references needed or quotations. Only a general idea or opinion.
A.
· Compare and contrast two works from the Italian Baroque period with two works from the Renaissance. Be sure to note the appearance in the works of the defining characteristics from each period.
· Discuss why artistic expression shifted from the restrained stoicism of the Renaissance to that of the heightened emotion in the religious and other works of the Baroque.
B. From video
Goya -
The Third of May
- If you cannot see this video, click here -
https://youtu.be/e7piV4ocukg
Respond in writing to the following questions after reading Chapter 12, watching the video, and exploring the sites above.
1. Heroism, nationalism, and passion are themes associated with Romanticism. Which
three
landmarks of the nineteenth century are most representative of these themes? You can discuss art, philosophy, or literature.
2. Compare Neoclassicism and Romanticism as styles and sensibilities. What do their differences reflect about patronage, popular taste, and historical change? Provide specific examples from the chapters.
C.
1. From the arts of West Africa, what are some characteristics of African cultural heritage?
2. How did their religious beliefs influence their art and music.
D.
Watch video below
Manet -
Déjeuner
sur
l’herbe -
If you cannot see this video, click
https://youtu.be/3xBGF8H3bQ4
1. Viewers of Manet’s
Déjeuner sur l’herbe
initially responded to its public display by attacking the canvas with their umbrellas. Why?
2. What kind of art has evoked a comparable response in our own time? Do some research online. Find a recent work of art that caused controversy. Summarize the reasons for the controversy and your reaction to it. Try not post the same article as someone else. (This board is not POST FIRST, so you will be able to see what others have posted right away.) If you can, attach a picture of the image you are describing to your posting.
E.
Watch the video below. If you cannot see the video, click here:
https://youtu.be/XyLNPumMMTs
George Braque, Violin and Pitcher, (1909)
•
Pablo Picasso, Guernica, (1937)
•
Marcel Duchamp, Nude Descending a Staircase, (1912)
Respond in writing to the following question after reading Chapter 14 in your text, watching the video above, viewing the Web Assignments, and the sites above.
1. Describe how they three have departed from styles such as symbolism and impressionism of the late nineteenth century.
F.
Take some time to reflect on all we have covered in this course. Then, respond in writing to the following question.
1. After your experience in this course, describe why you feel the humanities are important.
Edit question's body
.
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
for beginners, providing thorough training in areas such as SEO, digital communication marketing, and PPC training in Noida. After finishing the program, students receive the certifications recognised by top different universitie, setting a strong foundation for a successful career in digital marketing.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
1. 352 BUMC PROCEEDINGS 2001;14:352–357
The technological advances of the past century tended tochange
the focus of medicine from a caring, service-oriented model to a
technological, cure-oriented model.
Technology has led to phenomenal advances in medicine and
has given us the ability to prolong life. However, in the past
few
decades physicians have attempted to balance their care by re-
claiming medicine’s more spiritual roots, recognizing that until
modern times spirituality was often linked with health care.
Spiritual or compassionate care involves serving the whole per-
son—the physical, emotional, social, and spiritual. Such service
is inherently a spiritual activity. Rachel Naomi Remen, MD,
who
has developed Commonweal retreats for people with cancer, de-
scribed it well:
Helping, fixing, and serving represent three different ways of
see-
ing life. When you help, you see life as weak. When you fix,
you
see life as broken. When you serve, you see life as whole.
Fixing
and helping may be the work of the ego, and service the work of
the soul (1).
Serving patients may involve spending time with them, hold-
ing their hands, and talking about what is important to them.
Patients value these experiences with their physicians. In this
article, I discuss elements of compassionate care, review some
research on the role of spirituality in health care, highlight ad-
2. vantages of understanding patients’ spirituality, explain ways to
practice spiritual care, and summarize some national efforts to
incorporate spirituality into medicine.
COMPASSIONATE CARE: HELPING PATIENTS FIND
MEANING IN
THEIR SUFFERING AND ADDRESSING THEIR
SPIRITUALITY
The word compassion means “to suffer with.” Compassionate
care calls physicians to walk with people in the midst of their
pain, to be partners with patients rather than experts dictating
information to them.
Victor Frankl, a psychiatrist who wrote of his experiences in
a Nazi concentration camp, wrote: “Man is not destroyed by
suf-
fering; he is destroyed by suffering without meaning” (2). One
of the challenges physicians face is to help people find meaning
and acceptance in the midst of suffering and chronic illness.
Medical ethicists have reminded us that religion and spiritual-
ity form the basis of meaning and purpose for many people (3).
At the same time, while patients struggle with the physical as-
pects of their disease, they have other pain as well: pain related
to mental and spiritual suffering, to an inability to engage the
deepest questions of life. Patients may be asking questions such
The role of spirituality in health care
CHRISTINA M. PUCHALSKI, MD, MS
From The George Washington Institute for Spirituality and
Health (GWish), The
George Washington University Medical Center Departments of
Medicine and
Health Care Sciences, and The George Washington University,
Washington, DC.
3. Presented at Baylor University Medical Center on February 28,
2001, as the Baylor-
Charles A. Sammons Cancer Center Charlotte Johnson Barrett
Lectureship.
Corresponding author: Christina M. Puchalski, MD, MS,
GWish, 2300 K Street NW,
Warwick Building, Room 336, Washington, DC 20037.
as the following: Why is this happening to me now? What will
happen to me after I die? Will my family survive my loss? Will
I
be missed? Will I be remembered? Is there a God? If so, will he
be there for me? Will I have time to finish my life’s work? One
physician who worked in the pediatric intensive care unit told
me about his panic when his patients’ parents posed such ques-
tions. It is difficult to know what to say; there are no real an-
swers. Nevertheless, people long for their physicians as well as
their families and friends to sit with them and support them in
their struggle. True healing requires answers to these questions
(3). Cure is not possible for many illnesses, but I firmly believe
that there is always room for healing. Healing can be
experienced
as acceptance of illness and peace with one’s life. This healing,
I
believe, is at its core spiritual.
Two examples illustrate ways to deal with questions related
to meaning in life. Many studies have shown that people desire
to be remembered (4). Some wish to fulfill this desire through
their family, and others through their life’s accomplishments or
impact. One of my patients has had ovarian cancer for 71⁄ 2
years.
Recently, the cancer metastasized and is no longer as responsive
to chemotherapy. She has been involved in lecturing to a class
4. of my medical students for a 2-week period each semester, talk-
ing about medical care from a patient’s perspective. Now that
she
is facing the end of her life, she is determined to continue those
lectures; she finds purpose in the significant impact they have
had on future physicians. Her treatment team was able to work
around certain therapeutic protocols to enable her to achieve her
dreams and goals. Another patient was dying of breast and ova-
rian cancer in her early 30s, and she was depressed. Antidepres-
sants weren’t helping. Through talking with her, I understood
the cause of her suffering: a fear that her 2-year-old daughter
would not remember her. I suggested that she keep a journal to
leave to her daughter; the hospice nurses videotaped her
messages
to her children. These activities helped resolve her depression.
Erik Erikson has written about certain developmental tasks
that he suggests children, adolescents, and adults need to
accom-
OCTOBER 2001 353
plish as part of the normal developmental and maturing process
(5). Spirituality has been recognized by many authors as an in-
tegral developmental task for those who are dying (6, 7). Un-
fortunately, people who are dying are often ignored. DNR—do
not resuscitate—is often interpreted as “do not round.” As these
patients deal with issues of transcendence, they need someone
to be present with them and support them in this process. We
need to advocate for systems of care in which that can happen.
Attending the dying patient is an important experience for
physicians as well. In an article entitled “When mortality calls,
don’t hang up,” Sally Leighton wrote: “The physician will do
5. better to be close by to tune in carefully on what may be tran-
spiring spiritually, both in order to comfort the dying and to
broaden his or her own understanding of life at its ending” (8).
One Baylor nurse I spoke with said that her patients give back
400% more than she gives them. I have to echo that sentiment.
Being in the presence of people who are struggling and are able
to transcend suffering and pain and see life in a different way is
inspiring for me, and I’m grateful for those experiences.
RESEARCH ON THE ROLE OF SPIRITUALITY IN HEALTH
CARE
The effect of spirituality on health is an area of active re-
search right now. Besides being studied by physicians, it is
stud-
ied by psychologists and other professionals. The studies tend
to
fall into 3 major areas: mortality, coping, and recovery.
Mortality
Some observational studies suggest that people who have
regular spiritual practices tend to live longer (9). Another study
points to a possible mechanism: interleukin (IL)-6. Increased
levels of IL-6 are associated with an increased incidence of dis-
ease. A research study involving 1700 older adults showed that
those who attended church were half as likely to have elevated
levels of IL-6 (10). The authors hypothesized that religious
com-
mitment may improve stress control by offering better coping
mechanisms, richer social support, and the strength of personal
values and worldview.
Coping
Patients who are spiritual may utilize their beliefs in coping
6. with illness, pain, and life stresses. Some studies indicate that
those who are spiritual tend to have a more positive outlook and
a better quality of life. For example, patients with advanced
can-
cer who found comfort from their religious and spiritual beliefs
were more satisfied with their lives, were happier, and had less
pain (11). Spirituality is an essential part of the “existential do-
main” measured in quality-of-life scores. Positive reports on
those
measures—a meaningful personal existence, fulfillment of life
goals, and a feeling that life to that point had been
worthwhile—
correlated with a good quality of life for patients with advanced
disease (12).
Some studies have also looked at the role of spirituality re-
garding pain. One study showed that spiritual well-being was
related to the ability to enjoy life even in the midst of
symptoms,
including pain. This suggests that spirituality may be an impor-
tant clinical target (13). Results of a pain questionnaire distrib-
uted by the American Pain Society to hospitalized patients
showed that personal prayer was the most commonly used non-
drug method of controlling pain: 76% of the patients made use
of it (14). In this study, prayer as a method of pain management
was used more frequently than intravenous pain medication
(66%), pain injections (62%), relaxation (33%), touch (19%),
and massage (9%). Pain medication is very important and
should
be used, but it is worthwhile to consider other ways to deal with
pain as well.
Spiritual beliefs can help patients cope with disease and face
death. When asked what helped them cope with their gyneco-
logic cancer, 93% of 108 women cited spiritual beliefs. In addi-
7. tion, 75% of these patients stated that religion had a significant
place in their lives, and 49% said they had become more spiri-
tual after their diagnosis (15). Among 90 HIV-positive patients,
those who were spiritually active had less fear of death and less
guilt (16). A random Gallup poll asked people what concerns
they would have if they were dying. Their top issues were find-
ing companionship and spiritual comfort—chosen over such
things as advance directives, economic/financial concerns, and
social concerns. Those who were surveyed cited several
spiritual
reassurances that would give them comfort. The most common
spiritual reassurances cited were beliefs that they would be in
the
loving presence of God or a higher power, that death was not
the end but a passage, and that they would live on through their
children and descendants (17).
Bereavement is one of life’s greatest stresses. A study of 145
parents whose children had died of cancer found that 80% re-
ceived comfort from their religious beliefs 1 year after their
child’s
death. Those parents had better physiologic and emotional ad-
justment. In addition, 40% of those parents reported a strength-
ening of their own religious commitment over the course of the
year prior to their child’s death (18).
These findings are not surprising. We hear them repeated in
focus groups, in patients’ writings and stories: When people are
challenged by something like a serious illness or loss, they fre-
quently turn to spiritual values to help them cope with or un-
derstand their illness or loss.
Recovery
Spiritual commitment tends to enhance recovery from illness
and surgery. For example, a study of heart transplant patients
8. showed that those who participated in religious activities and
said
their beliefs were important complied better with follow-up
treat-
ment, had improved physical functioning at the 12-month
follow-up visit, had higher levels of self-esteem, and had less
anxi-
ety and fewer health worries (19). In general, people who don’t
worry as much tend to have better health outcomes. Maybe
spiri-
tuality enables people to worry less, to let go and live in the
present moment.
Related to spirituality is the power of hope and positive think-
ing. In 1955, Beecher showed that between 16% and 60% of pa-
tients—an average of 35%—benefited from receiving a placebo
for pain, cough, drug-induced mood change, headaches, seasick-
ness, or the common cold when told that the placebo was a drug
for their condition (20). Now placebos are used only in clinical
trials, and even there, generally about 35% of people respond to
them. Study of the “placebo effect” has led to conclusions that
our beliefs are powerful and can influence our health outcomes.
Herbert Benson, MD, a cardiologist at Harvard School of Medi-
THE ROLE OF SPIRITUALITY IN HEALTH CARE
354 BAYLOR UNIVERSITY MEDICAL CENTER
PROCEEDINGS VOLUME 14, NUMBER 4
cine, has renamed the placebo effect “remembered wellness”
(21).
I see this as an ability to tap into one’s inner resources to heal.
Benson, myself, and others see the physician-patient
relationship
9. as having placebo effect as well—i.e., the relationship itself is
an
important part of the therapeutic process. Benson suggests that
there are 3 components that contribute to the placebo effect of
the patient-physician relationship: positive beliefs and expecta-
tions on the part of the patients, positive beliefs and
expectations
on the part of the physician or health care professional, and a
good
relationship between the 2 parties (21).
Specific spiritual practices have been shown to improve health
outcomes. In the 1960s, Benson began research on the effect of
spiritual practices on health. Some people who practiced tran-
scendental meditation approached him in the 1960s and asked
him to determine if meditation had beneficial health effects. He
found that 10 to 20 minutes of meditation twice a day leads to
decreased metabolism, decreased heart rate, decreased
respiratory
rate, and slower brain waves. Further, the practice was
beneficial
for the treatment of chronic pain, insomnia, anxiety, hostility,
depression, premenstrual syndrome, and infertility and was a
use-
ful adjunct to treatment for patients with cancer or HIV. He
called this “the relaxation response.” Benson concluded: “To
the
extent that any disease is caused or made worse by stress, to
that
extent evoking the relaxation response is effective therapy”
(22).
Different studies suggest that 60% to 90% of all patient vis-
its to primary care offices are related to stress. I teach the relax-
ation response to many of my patients, and I have found it
particularly useful for patients with chronic pain, high blood
10. pressure, headaches, and irritable bowel syndrome. It takes only
a few minutes to describe the meditation and to practice it with
your patient in the office. The patient then needs to practice the
technique at home. I usually suggest people follow up with me
in the office more frequently initially as they are learning the
technique. After a few semimonthly visits, they switch to brief
monthly visits, which can then be tapered. Some of my patients
follow up with me by phone if coming to my office frequently is
difficult.
ADVANTAGES OF BECOMING FAMILIAR WITH
PATIENTS’
SPIRITUALITY
Do patients want physicians to address their spirituality?
Research studies have also addressed this issue. In the USA
Weekend Faith and Health Poll, 65% felt that it was good for
doctors to speak with them about their spiritual beliefs, yet only
10% said a doctor had had such a conversation with them (23).
A study of pulmonary outpatients at the University of Pennsyl-
vania found that 66% agreed that a physician’s inquiry about
spiritual beliefs would strengthen their trust in their physician;
94% of patients for whom spirituality was important wanted
their
physicians to address their spiritual beliefs and be sensitive to
their values framework. Even 50% of those for whom spiritual-
ity was not important felt that doctors should at least inquire
about spiritual beliefs in cases of serious illness (24).
From a physician’s standpoint, understanding patients’ spiri-
tuality is quite valuable as well:
• Spirituality may be a dynamic in the patient’s understanding
of
the disease. For example, when I was a resident I saw a 28-
year-old woman whose husband had just left her. She found
11. out that her husband had AIDS, and she asked to be tested.
When I met with her to tell her that the test result came back
positive, I tried to explain that her illness was diagnosed early
and that there had been recent advances in the treatment
of HIV that were allowing people to live longer with their
illness. She kept referring to God and about why God was
doing this to her. I recognized that we weren’t connecting,
so I asked her about her comments. She proceeded to tell me
about being raped as a teenager and having an abortion. In
her belief system, that was wrong. I remember her exact
words: “I have been waiting for the punishment, and this is
it.” She did not want to discuss treatment or preventive care
such as immunization. I encouraged her to see a chaplain,
which she did regularly. In the meantime, I kept seeing her,
and I talked with her about her issues of guilt and punish-
ment as well as some education about HIV. But it was not
until 1 year later that she was willing to seek treatment. She
needed time to work out her own issues of guilt before being
able to accept her illness and deal with it. Now, she tells me
that had I not addressed her spiritual issues in that first visit,
she would never have returned to see me or any other physi-
cian. In many patients’ lives, spiritual or religious beliefs may
affect the decisions they make about their health and illness
and the treatment choices they make. It is critical that we
as physicians and health care providers listen to all aspects
of our patients’ lives that can affect their decision making and
their coping skills.
• Religious convictions may affect health care decision making.
Jehovah’s Witness patients rejecting blood transfusions is a
classic example, but there are also beliefs around use of ven-
tilators and feeding tubes. One of my patients was an 88-year-
old man dying of pancreatic cancer in the intensive care unit.
He was on a ventilator. When the treatment team approached
his family about withdrawing support, at first they refused,
12. saying that their father was in God’s hands and keeping him
on support might make a miracle possible. After an ethics
consult and a consult with a chaplain, the family had the
chance to reframe their own thinking. Eventually, they saw
that a peaceful death and their father’s union with God could
be the miracle. The critical elements in helping the family
deal with the situation were the medical team’s respecting and
not ridiculing the family’s beliefs and the chaplain’s skill in
counseling and helping the family reconcile their religious
beliefs with the reality of their father’s dying.
• Spirituality may be a patient need and may be important in pa-
tient coping. This was true of a patient of mine who died 2
weeks ago. She used her religious beliefs and practices to help
her live with serious chronic illness. Many of the 1500 people
at her funeral commented on her deep faith and how her
spirituality helped her cope with her multiple strokes and
diabetes. Towards the end of her life, she was in a coma. Her
family asked me to join them in their prayer around their
mother’s bedside. During the prayer, the family was able to
express both their hope in her recovery, but also their request
to God for strength to deal with her death if that was to be
the outcome. So, for both my patient and my patient’s fam-
ily, spiritual beliefs and practices were the main resource they
used to cope with suffering and loss. And this patient and her
OCTOBER 2001 355
family wanted me, their physician, to be aware of these be-
liefs and to be open to hearing their spiritual expressions in
the clinical setting. Patients may want to discuss their spiri-
tuality with their physician, to use their church group as a
social support, or to join faith-based organizations for sup-
port and guidance.
13. • An understanding of the patient’s spirituality is integral to
whole
patient care. One of my patients, a 42-year-old woman with
irritable bowel syndrome, had several signs of depression,
including insomnia, excessive worrying, decreased appetite,
and anhedonia. Overall, she felt she had no meaning and
purpose in life. She did not respond to medication and diet
changes alone. I taught this patient the relaxation response
as an adjunct to the medical treatment and counseling she
received. She improved when meditation and counseling
were added to the treatment regimen.
As shown in the first example of the woman who was HIV
positive, some spiritual stances can lead to negative coping:
more
depression, poorer quality of life, and callousness towards oth-
ers. This is seen when patients view a crisis as a punishment
from
God, have excessive guilt, or have absolute belief in prayer and
a cure and then can’t resolve their anger when the cure does not
occur. Generally, however, spirituality leads to positive coping.
Patients seek control through a partnership with God, ask God’s
forgiveness and try to forgive others, draw strength and comfort
from their spiritual beliefs, and find support from a spiritual or
religious community. These actions lead to less psychological
distress (25).
ASPECTS OF SPIRITUAL CARE
What is involved in serving patients and providing compas-
sionate care? Physicians can begin with the following:
• Practicing compassionate presence—i.e., being fully present
and attentive to their patients and being supportive to them
in all of their suffering: physical, emotional, and spiritual
14. • Listening to patients’ fears, hopes, pain, and dreams
• Obtaining a spiritual history
• Being attentive to all dimensions of patients and their fami-
lies: body, mind, and spirit
• Incorporating spiritual practices as appropriate
• Involving chaplains as members of the interdisciplinary
health care team
Throughout these activities, it is important to understand
professional boundaries. In-depth spiritual counseling should
occur under the direction of chaplains and other spiritual lead-
ers, as they are the experts. The physician should not initiate
prayer with patients, as this blurs the boundary of physician and
clergy. Leading prayer involves specific skills and training that
physicians do not have. Furthermore, a physician leading a
prayer
might lead a prayer from his or her tradition, which could be
offensive or inappropriate for the patient. If the patient requests
prayer, the physician can stand by in silence as the patient prays
in his or her tradition or can contact the chaplain to lead a
prayer.
Finally, the spiritual history is patient centered, and proselytiz-
ing and ridiculing patients’ beliefs are not acceptable.
It is important to recognize that patients come to physicians
to seek care for their medical condition. In delivering this care,
physicians can be respectful and understand the spiritual dimen-
sion in patients’ lives. But to go beyond that, e.g., to lead
prayer
or provide in-depth spiritual counseling, is inappropriate. Phy-
sicians are in a position of power with patients. Most patients
come to us in vulnerable times. If the physician suggests a cer-
15. tain religion/spiritual belief or ridicules a patient’s belief, the
patient might adopt that physician’s belief or lack of belief out
of fear of disagreeing with a perceived authority. Therefore, it
is
critical that when discussing spiritual issues with patients, the
physician listens and supports and does not guide or lead.
Many physicians are not familiar with spiritual histories. I’ve
developed the “FICA” questions to guide the conversation
(Table
1). I teach medical students and physicians to take a spiritual
history as part of a social history, at each annual exam, and at
follow-up visits as appropriate. A spiritual history helps physi-
cians recognize when cases need to be referred to chaplains. It
opens the door to conversation about values and beliefs, uncov-
ers coping mechanisms and support systems, reveals positive
and
negative spiritual coping, and provides an opportunity for com-
passionate care.
NATIONAL RECOGNITION OF THE VALUE OF SPIRITUAL
CARE
Several prominent organizations have recognized the impor-
tance of spiritual care. The Joint Commission on Accreditation
of Healthcare Organizations has a policy that states: “For many
patients, pastoral care and other spiritual services are an
integral
part of health care and daily life. The hospital is able to provide
for pastoral care and other spiritual services for patients who re-
quest them” (26).
The American College of Physicians convened an end-of-
life consensus panel that concluded that physicians should ex-
tend their care for those with serious medical illness by
attention
16. to psychosocial, existential, or spiritual suffering (27). In addi-
tion, the Association of American Medical Colleges (AAMC)
has embarked on a study of medical education. It convened a
consensus group of deans and faculty of medical schools to de-
termine the key elements of a medical school curriculum. In its
first report, it listed the essential attributes of physicians. The
first
attribute is that physicians should be altruistic: “Physicians
must
be compassionate and empathic in caring for patients. . . . In all
of their interactions with patients, they must seek to understand
the meaning of the patients’ stories in the context of the
patients’
Table 1. The FICA method of taking a spiritual history
F Faith and belief. Ask: Are there spiritual beliefs that help you
cope
with stress or difficult times? What gives your life meaning?
I Importance and influence. Ask: Is spirituality important in
your life?
What influence does it have on how you take care of yourself?
Are
there any particular decisions regarding your health that might
be
affected by these beliefs?
C Community. Ask: Are you part of a spiritual or religious
community?
A Address/action. Think about what you as the health care
provider
need to do with the information the patient shared—e.g., refer
to a
chaplain, meditation or yoga classes, or another spiritual
18. students
learn all aspects of the history—physical, social, emotional, and
spiritual.
The John Templeton Foundation supports the development
of curricula on spirituality and medicine in medical schools and
in residency training programs. The grant program has been suc-
cessful: not only do the schools and programs continue the cur-
ricula after the funding ends, but even schools that have applied
and not received funding continue to offer the course. One of
the requirements to apply for the award is to have approval from
the dean and necessary education committees to offer the
course.
Once this is done, many schools elect to offer the course even if
funding is not awarded. This suggests that medical school fac-
ulty find the topic of spirituality and health relevant to medical
education and patient care.
The AAMC has also addressed the curriculum in spiritual-
ity, cultural issues, and end-of-life care. In its third report, the
association outlined outcome goals and learning objectives for
spirituality (Table 2). First, the consensus group noted that we
are coming to understand health as a process by which individu-
als maintain their sense of coherence and meaning in life in the
face of changes in themselves such as illness (29). So, spiritual-
ity can be seen as that part of people that sees coherence, mean-
ing, and purpose in their lives. The AAMC’s definition of
spirituality is a broad one:
Spirituality is recognized as a factor that contributes to health
in
many persons. The concept of spirituality is found in all
cultures and
societies. It is expressed in an individual’s search for ultimate
mean-
ing through participation in religion and/or belief in God,
19. family,
naturalism, rationalism, humanism, and the arts. All of these
fac-
tors can influence how patients and health care professionals
per-
ceive health and illness and how they interact with one another
(30).
Furthermore, the consensus group of faculty that developed
the definition also developed guidelines and learning objectives
for teaching these courses. One of the basic premises of these
courses is that focusing on the spiritual aspect of patients
enables
one to deliver more compassionate care.
In summary, spirituality can be an important element in the
way patients face chronic illness, suffering, and loss. Physicians
need to address and be attentive to all suffering of their pa-
tients—physical, emotional, and spiritual. Doing so is part of
delivery of compassionate care. I think we can be better physi-
cians and true partners in our patients’ living and in their dying
if we can be compassionate: if we truly listen to their hopes,
their
fears, and their beliefs and incorporate these beliefs into their
therapeutic plans.
1. Remen RN. Kitchen Table Wisdom: Stories That Heal. New
York: Riverhead
Books, 1997.
2. Frankl VE. Man’s Search for Meaning. New York: Simon and
Schuster, 1984.
3. Foglio JP, Brody H. Religion, faith, and family medicine. J
Fam Pract 1988;
20. 27:473–474.
4. VandeCreek L, Nye C. Trying to live forever: correlates to
the belief in life
after death. Journal of Pastoral Care 1994;48(3).
5. Erikson E. Childhood in Society. New York: Norton, 1950.
6. Derrickson BS. The spiritual work of the dying: a framework
and case stud-
ies. Hosp J 1996;11:11–30.
7. Moberg D. Spiritual well-being of the dying. In Lesnoff-
Caravaglia G, ed.
Aging and the Human Condition. New York: Human Science
Press, 1982.
Table 2. Recommendations of the Association of American
Medical
Colleges for a Curriculum on Spirituality*
Outcome goals
Students will be aware that spirituality, and cultural beliefs and
practices,
are important elements of the health and well-being of many
patients.
They will be aware of the need to incorporate awareness of
spirituality,
and culture beliefs and practices, into the care of patients in a
variety of
clinical contexts. They will recognize that their own
spirituality, and
cultural beliefs and practices, might affect the ways they relate
to, and
provide care to, patients.
Students will be aware of the range of end-of-life care issues
and when
21. such issues have or should become a focus for the patient, the
patient’s
family, and members of the health care team involved in the
care of the
patient. They will be aware of the need to respond not only to
the physi-
cal needs that occur at the end of life, but also the emotional,
sociocul-
tural, and spiritual needs that occur.
Learning Objectives
With regard to spirituality and cultural issues, before graduation
students
will have demonstrated to the satisfaction of the faculty:
• The ability to elicit a spiritual history
• An understanding that the spiritual dimension of people’s
lives is an
avenue for compassionate caregiving
• The ability to apply the understanding of a patient’s
spirituality and
cultural beliefs and behaviors to appropriate clinical contexts
(e.g., in
prevention, case formulation, treatment planning, challenging
clinical
situations)
• Knowledge of research data on the impact of spirituality on
health and
on health care outcomes, and on the impact of patients’ cultural
iden-
tity, beliefs, and practices on their health, access to and
interactions
with health care providers, and health outcomes
22. • An understanding of, and respect for, the role of clergy and
other
spiritual leaders, and culturally based healers and care
providers, and
how to communicate and/or collaborate with them on behalf of
pa-
tients’ physical and/or spiritual needs
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THE ROLE OF SPIRITUALITY IN HEALTH CARE