Musical Psychotherapy: History, Effects, and Applications

Musical Psychotherapy: History, Effects, and Applications Samah El Saadi Abstract We all enjoy music as a form of art but we rarely take into consideration the effect of the music that we listen to. Music therapy is using music in a therapeutic manner in order to recover or stabilize a mental, physical or psychological state. This review will introduce music therapy and trace its origins back in history, and then it will give an insight on music related neurosciences explaining what parts of the brain and neurotransmitters are involved. Music can affect us on many different levels; however, this review will focus on the ability of music to aid in psychotherapy. It is important to highlight that the potential power within music can be either constructive or destructive depending on the choice of music. Musical Psychotherapy What is music therapy and what are the origins? Everyone sees music as a form of art that they enjoy playing or dancing on its rhythms as they tend to develop a preference to certain type of rhythms. However, seldom do people think of the impact of music on their health although through their experiences with music they would know that their favorite type of music can make them feel relaxed, happy or even anxious. But have you ever considered music as a form of therapy? Research showed that music does have an effect on our health and it can be either positive or negative depending on the music, yet these effects are mediated through psychology and neurosciences (News in Health [NIH], 2010). Music therapy is applying music as a tool in order to improve, stabilize or restore an emotional, mental, or physical health. It is conducted by accredited music therapists who are able to skillfully use music and music elements in assessing patients, developing treatment plans, evaluating progresses and contribute in research (Music Therapy Association [MTAO], 2010). Music therapists plan music sessions for individuals or groups and may use active or passive approaches in the therapy depending on the patients’ need. The therapy may include listening to music, making music, talking about the lyrics or even writing songs, but definitely it is not restricted to people with musical abilities. Since music is accessible everywhere, music therapy is not limited to a place and sessions can be arranged at homes, hospitals, hospices, care centers or any calm place people may prefer (American Cancer Society [ACS], 2008). The nonverbal emotional entity of music makes it a universal langu age that can ease the self-expression, personal development and social interactions which would aid in psychotherapy. Music can always have a positive impact on people whether they are ill, disabled or perfectly healthy (MTAO, 2010). The principle of therapeutic use of music is not new, ancient cultures were aware of music power which for some was part of their traditional healing practices such as the case of Native Americans (ACS, 2008). The musical power of healing was marked in different ethnic ancient inscriptions like that of Rome, India, China and Egypt (Music as Medicine, 2014), as it was mentioned in the writings of Greek philosophers such as Aristotle, Pythagoras and Plato (ACS, 2008). However the modern music therapy dates back to World War II when music was used to help in the treatment of soldiers who were suffering from shell shock, and it was in 1944 when Michigan State University initiated the first degree program in music therapy (ACS, 2008). Music related neurosciences For many years research was ongoing to understand the means of action of music and why it does have this strong impact on our lives. Since the impact is mediated neurologically, scientists intensively investigated the brain regions and with the help of the emerging imaging techniques such as functional magnetic resonance imaging (fMRI) they noticed that it activates unexpected regions involved in emotions and memory, in addition to the brain’s motor regions that are responsible for coordinating physical movements. The neuroscientist Dr. Petr Janata in his recent studies proved that the area of the brain serving as a central hub between music, emotions and memories is the medial prefrontal cortex. In an attempt to understand the medial prefrontal cortex activity, young adults were subjected to extracts of childhood songs while being monitored with fMRI and it was noticed that the activity was optimal when they heard a familiar song that call to mind an emotion or memory (NIH, 2 010). Dr. Janata stated that in Alzheimer patients the medial prefrontal cortex is one of the last brain regions to deteriorate, hence this explains why patients with Alzheimer may recall childhood tunes whereas other memories are lost. In further investigation on the medial prefrontal cortex activity, Dr. Allen Braun and Dr. Charles Limb monitored via magnetic resonance imaging (MRI) scanner the medial prefrontal cortex in a jazz musician as he played his music. The doctors noticed that the region was not active when the musician played a memorized tune; however, it became active when the musician was improvising concluding that the medial prefrontal cortex also has a role in the creative expression of music (NIH, 2010). Going deeper into the music impact on the neurological level, an experiment was done to check the neurotransmitters involved and the time of their release. Via the ligand-based positron emission tomography (PET) scientists discovered that music triggers dopamine release in both the dorsal and ventral striatum. Nevertheless, this discovery was not surprising since dopamine is known to be responsible for the pleasure sensation whether due to sex, drugs or just music. But the more interesting discovery was the monitoring of the increase in dopaminergic voxels in the right nucleus accumbens (NAcc) preceding a favorite part and peaking when the favorite part was reached. The phase of increased dopaminergic voxels prior to the favorite part was termed Anticipatory phase, as depicted in the figure 1, and it prepares us for the subsequent musical part that we love and will cause the dopamine peek giving us the pleasure sensation (Salimpoor et al, 2011). To have a better understanding, scientists took a closer look on the music itself. Early theories about music argued that we get affected by music through the connotative meanings and mental images that it reflects; however, according to the musicologist Leonard Meyer it is the ambiguity and not knowing what the next note will be is what keeps us waiting in excitement. Repetitive expected patterns in music is boring and can be annoying like an alarm clock, hence it is the unpredictable patterns that give us the chills. Meyer stated that the uncertainty is what triggers the release of dopamine as we try to figure out what the next note is. We may be able to predict some of the notes but not all of them and that is what cause our brains to plead for those notes that will unleash the uncertainty and completes the pattern, yet these notes are usually spared till the end to keep us listening (WIRED, 2011). Music therapy in clinical trials Now that we had an insight on the neuroscience that relies behind the effects of music, we should note that music has effects on both physical level and psychological level. Some of the physical effects are enhancing immunity, decreasing anxiety, and altering the blood pressure and heart rate (NIH, 2010), whereas at the psychological level music has the power to alter our mood and aid in psychotherapy. In this review we will be focusing on the psychological effects and its role in psychotherapy. Several clinical trials have been conducted in order to ensure the effectiveness of music therapy. In a clinical trial 46 patients diagnosed with depression were randomly separated into two groups. Group 1 was subjected to the standard care that includes antidepressant medication, psychotherapy and psychiatric counseling, whereas group 2 underwent 60 min music therapy sessions in addition to the standard care. The patients were assessed after 3 months and results showed that people who received music-therapy had less depressive symptoms from those who didn’t. Professor Christian Gold, one of the two study leaders, said: Music therapy has specific qualities that allow people to express themselves and interact in a non-verbal way even in situations when they cannot find the words to describe their inner experiences.† (Erkkilà ¤ et al, 2011). Another similar clinical trial that was done on 79 patients with low- and medium-grade depression revealed results that reinforces the ones that were retrieved by the first clinical trial mentioned here (Castillo-Perez et al, 2010). In a clinical trial on 80 schizophrenic patients, 42 patient where assigned to do music therapy for 60 minutes twice a week while 38 other patients were assigned to undergo standard care. After 3-month follow-up the results indicated improvement in the depression status and psychiatric symptoms of the patients (Lu et al, 2013). It is important to note that there is dose-effect relationship in music therapy by which more recurrent sessions would result in more considerable improvements (Gold et al, 2009). Can music be destructive? The power of music is just like any other power that can be either constructive or destructive depending on the usage. Nice music can lift you up and motivate you, but on the contrary sad or violent music can be destructive. In a study published in 2003 by the American Psychological Association (APA), researchers from Iowa State University examined the effect of violent lyrics by which they made students listen to seven violent songs and 8 nonviolent songs being sung by the same artist and using the same musical style in order to control the other factors, and then they were assessed for their aggressive thoughts and feelings through psychological tasks. The results showed an increase in the aggressive interpretations where Dr. Anderson, a lead researcher, stated that violent and aggressive music makes people biased toward aggressive interpretations, and this form of interpretations will eventually manifest in aggressive verbal and physical expressions and antisocialism (APA, 2003). What complicate things more is the fact that classification of music as beneficial or destructive can be subjective. In an investigative study 80 people were played the same songs but prior that some of them were told that the music is suicide-inducing and others were told the music is life-affirming. The study shows that depending on the prior labeling of the music the same songs were perceived by listeners as either suicide-inducing or life-affirming, thus it is the censorship and prior labeling that might give songs their harmful effects on listeners (North Hargreaves, 2005). As some people argued by saying that negative music gives them sensation of relief due to knowing that someone else felt in a particular way but was able to recover and be creative enough to express their emotions in such a way, hence for them it is perceived as a form of hope if they were in a similar situation (Baker Brown, 2014). Music therapy today and its other potential powers Nowadays degrees in music therapy are becoming more available worldwide as people are becoming more aware of the therapeutic role of music whether it is physical, mental or psychological. There are a lot more potential powers in music yet to be discovered such as its role when played in businesses and retails stores and how it can affect the customers’ behavior (Yalch, 1993), its effect on fetuses by which some claim that the choice of music of the pregnant women will affect their children later on (Kisilevsky et al, 2004), and how effectively does music help hospitalized patients in recoveries and in lessening their pain (ACS, 2008). Music is an entertaining form of art that is easily accessible to everyone and flexible enough to satisfy different tastes; these characteristics makes music a potential power that if people knew how to utilize it correctly, they would be seeking a better state of a harmonic life. References American Cancer Society. (2008). Music Therapy. Retrieved May 23, 2014, from http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/mindbodyandspirit/music-therapy American Psychological Association [APA]. (2003). Violent music lyrics increase aggressive thoughts and feelings, according to new study; Even humorous violent songs increase hostile feelings. ScienceDaily. Retrieved May 23, 2014, from http://www.sciencedaily.com/releases/2003/05/030505084039.htm Baker C. Brown B. (2014). Suicide, Self-Harm and Survival Strategies in Contemporary Heavy Metal Music: A Cultural and Literary Analysis. J Med Humanit. PMID: 24682627. Retrieved May 23, 2014, from http://www.ncbi.nlm.nih.gov/pubmed/24682627 Castillo-Perez S., Gomez-Perez V., Velasco M.C., Perez-Campos E. Mayoral M. (2010). Effects of music therapy on depression compared with psychotherapy. The Arts in Psychotherapy, volume 37(5), pp.381-390. Retrieved May 23, 2014, from http://www.sciencedirect.com/science/article/pii/S0197455610000857?np=y Erkkilà ¤ J., Punkanen M., Phil L., Fachner J., Ala-Ruona E., Pà ¶ntià ¶ I., Tervaniemi M., Vanhala M. Gold C. (2010). Individual music therapy for depression: randomized controlled trail. The British Journal of Psychiatry. Retrieved May 23, 2014, from http://bjp.rcpsych.org/content/199/2/132.full?sid=b97bc6bf-4b35-4c4f-8000-3111d1ef35f9#content-block Gold C., Solli H.P., Krà ¼ger V. Lie S.A. (2009). Dose-response relationship in music therapy for people with serious mental disorders: Systematic review and meta-analysis. Clinical Psychology Review, volume 29(3), pp.193-207. Retrieved May 23, 2014, from http://www.sciencedirect.com/science/article/pii/S0272735809000026 Kisilevsky S., Hains S.M., Jacquet A.Y., Grranier-Deferre C., Lecanuet J.P. (2004). Maturation of fetal responses to music. Dev Sci,volume 7(5):550-9. PMID: 15603288. Retrieved May 23, 2014, from http://www.ncbi.nlm.nih.gov/pubmed/15603288 Lu S.F., Lo C.H., Sung H.C., Hsieh T.C., Yu S.C., Chang S.C. (2013). Effects of group music intervention on psychiatric symptoms and depression in patients with schizophrenia. Complement Ther Med, volume 21(6):682-8. PMID: 24280478. Retrieved May 23, 2014, from http://www.ncbi.nlm.nih.gov/pubmed/24280478 Music as Medicine. (2014). History of Music Therapy. Retrieved May 23, 2014, from http://www.musicasmedicine.com/about/history.cfm Music Therapy Association of Ontario [MTAO]. (2010). Music Therapy Definition. Retrieved May 23, 2014, from http://www.musictherapyontario.com/Default.aspx?pageId=1090464 News in Health [NIH]. (2010). Music Matters for Body and Mind. Retrieved May 23, 2014, from http://newsinhealth.nih.gov/2010/January/feature1.htm North A.C. Hargreaves D.J. (2005). Brief report: Labelling effects on the perceived deleterious consequences of pop music listening. J Adolesc, volume 28(3):433-40. PMID: 15925693. Retrieved May 23, 2014, from http://www.ncbi.nlm.nih.gov/pubmed/15925693 Salimpoor V.N., Benovoy M., Larcher K., Dagher A. Zatorre R. J. (2011). Anatomically distinct dopamine release during anticipation and experience of peak emotion to music. Nature neurosciences, volume 14(2), pp.121-269. Retrieved May 23, 2014, from http://www.nature.com/neuro/journal/v14/n2/full/nn.2726.html WIRED. (2011). The Neurosciences Of Music. Retrieved May 23, 2014, from http://www.wired.com/2011/01/the-neuroscience-of-music/ Yalch R.F. (1993) Using Store Music For Retail Zoning: a Field Experiment. Advances in Consumer Research, volume 20, pp.632-636. Retrieved May 23, 2014, from http://www.acrwebsite.org/search/view-conference-proceedings.aspx?Id=7531

Native American/European Slave Trade Essay

A North American conception of slavery often begins and ends with the forced captivity of Africans. However, slave trading took root in many parts of the world over centuries. In particular, the eras of exploration and colonialism brought the institution of slavery to the forefront of world culture. As Europeans arrived in the Americas in increasing numbers, they found themselves sharing one surprising commonality with their Native American adversaries: the use of human captives for personal and cultural advantage. Brett Rushforth’s â€Å"A little flesh we offer you: the origins of Indian slavery in New France† and James Brooks’ â€Å"This evil extends especially†¦ to the feminine sex† examine the Euro-Native slave trade within the context of two vastly different colonial cultures, Canada (New France) and New Mexico. What common features united these two institutions, and what features differed them? Further, what social and historical factors account for those similarities and differences? Foremost, the New France and New Mexican institutions shared a general outcome in their slave trades: â€Å"cross-cultural negotiation† (Brooks, 281) and the creation of â€Å"mutually intelligible symbols through which cultural values, interests and needs could be defined† (Brooks 281). Indian tribes occupying New France territories (such as the Iroquois and the Ottawa) held a long tradition of utilizing captives as symbolic forces of peace. Warring tribes would offer captured humans as a show of good faith toward their adversaries. The captives served numerous roles: replacing fallen tribesmen (in everything from name to manner), representing retribution for injured tribes, stimulating population growth, and— most importantly—securing alliances with other tribes. When European colonialists arrived seeking Native American trade and military assistance, the New France tribes considered captive offerings to be the ultimate sign of respect and comrade-ship in dealing with their new visitors. In fact, one Sioux chief pronounced the following after offering his European visitors a captive slave: â€Å"No longer regard us as Sioux, but as Frenchmen† (Rushforth, 789). Once the French realized the power of slaves in fostering alliances with the natives, they were able to build some formidable allegiances. Likewise, New Mexican Europeans created strong bonds with local Pueblo, Navajo, and Apache tribes through captive trading. Captive Spaniards and Indians often performed important social functions within their new homes. (Women were the ideal captive candidates for both New Mexico and New France, due to their reproductive capacities). Standard-bearers such as Maria Rosa Villalpando and Juana Hurtado Galvan demonstrated the importance of the captive within New Mexican culture. Both women served as interpreters and emissaries amongst their former and current tribes, and both secured prominent positions within their captive homes. The captured women of New Mexican society also fulfilled important economic roles within the larger society, contributing especially to hide-tanning and other trading enterprises. Similarly, captives in New France worked as domestics, farm hands, dock loaders, and at other semi-skilled jobs. While both New France and New Mexican colonialists both eventually accepted the institution of slavery (with averages of five and fifteen percent for their respective slave populations), they shared an initial reluctance to engage in the practice. For the Frenchmen, slavery was an institution forbidden by their own government. Therefore, they approached any attempted slave trades with the natives with reluctance or even hostility. However, an incident involving Daniel Dulhur (in which a refusal of bartered captives resulted in a near-catastrophic isolation of Indian tribes) crystallized the importance of alliance-making captives for the French. This consideration, combined with â€Å"laborers [which were] scarce and extraordinarily expensive in Canada†(Rushforth, 801), coerced the French government to legalize Indian slave trading in the colonies. Conversely, the New Mexico colonialists were somewhat quicker to engage in slave trading as a means to â€Å"redeem indigenous captives† (Brooks, 281) and â€Å"baptize them into the Catholic faith† (Brooks, 282). They even offered captives the opportunity to become citizens after twenty years of service. Soon, New Mexico villagers would further realize the ability of slave trading to â€Å"foster mutual exchanges with a minimal loss of life† (Brooks, 292). Both societies would soon engage in trade fairs and bartering as if the practices were second nature: â€Å"two good horses and some trifles† for an â€Å"Indian girl twelve to twenty years old† (Brooks, 282). The results of EuroNative trading systems up North and down South differed markedly, with respect to both the slaves themselves and larger society. Captives in New Mexico generally boasted a much more peaceful existence than their New France counterparts. While New France slaves could do little to raise their station in life, New Mexico captives often enjoyed increases in freedom and circumstances (although they shared the stigma of coercive sexual practices with New France female captives). Many female captives, for instance, were able to eventually purchase lands from their captors. The children of said captives also enjoyed full citizenship within their societies (the â€Å"hope† counteracting the â€Å"shame† (Brooks, 296) of sexual coercion), a luxury not afforded to the mixed-bloods of New France. New France slaves were viewed more as objects (whether they were objects of trade or objects of allegiance): â€Å"Here is a little flesh we offer you† (Rushforth, 794). Meanwhile, New Mexico captives were often adopted by their captive families, securing protection and affection from their new families. In fact, many captives chose willingly to â€Å"remain in their host societies throughout their lifetimes† (Brooks, 284), even when they were afforded a chance at freedom. One captive woman even refused a one thousand dollar ransom for her return. On the other hand, New France captives were the constant subject of derogatory terms and â€Å"a life of consistent, coerced, and degraded labor† (Rushforth, 780). In a larger context, systems of slave trading brought derision and division to both New Mexico and New France, albeit with different outcomes. For its part, New Mexico slave trading intensified the caste-like division between mestizos and genizaros and espanoles. Women often feared a return to their previous homes in part due to a belief that they would be ridiculed and outcast by pure Spaniards. Class consciousness did increase in relation to the rising mestizo population, as did the relationship between New Mexico villagers and Native Americans. Santa Fe administrators blamed the rising rebelliousness of the villagers on â€Å"bad upbringing†¦. from†¦the proximity and trade of the barbarous tribes† (Brooks, 293). The emerging alliance between villagers and Native Americans peaked with a joint siege and execution of Santa Fe officials in 1837, when the natives and villagers made â€Å"the same cause†¦. and same interests† (Brooks, 294). However, the â€Å"mixed-bloods† of New Mexico soon found their unique identity and place within larger American culture. In New France, the outcome of the slave trade was more subtle, as chattel slavery gradually emerged as the new trend, thus leading to a system which â€Å"rewarded brutality with valuable goods† (Rushforth, 808). In an ironic twist, the slave system which once served as a â€Å"partial defeat of France’s power over its Indian neighbors† (Rushforth, 808) transformed into an institution where French colonialists â€Å"redirected their impulse for control and domination onto distant Indian nations† (Rushforth, 808). Why did slave trading in New Mexico have a slightly more positive outcome than in New France? For one, New Mexico tribes and societies were â€Å"enhanced by traditions of matri- lineality and social mobility† (Brooks, 287), which put the primarily female captives in a much more secure position within their new homes. The importance of women in the textile culture of the natives automatically raised the status of all women, including the captives. Even captive men could make themselves useful, performing tasks such as gun repairing and saddle-making. The New Mexico captives simply had more opportunity, â€Å"negotiating narrow fields of agency with noteworthy skill† (Brooks, 284). More importantly, the resulting generation of mixed bloods which sprung from slave trading found themselves in a unique position of power, as their manpower and negotiating capabilities proved in high demand for colonialist forces. This new generation carved a niche and an identity for themselves which endures to this day, as evidenced by the musings of one descendent: â€Å"We have relatives in the Pueblos, and out there, in Oklahoma† (Brooks, 301). Within the conflict, the New Mexicans found coexistence—a principle which New France (and its more oppressive slavery practices) could never quite accomplish. References Brooks, J. F. (1996). This evil extends especially†¦ to the feminine sex: negotiating captivity in the New Mexico borderlands. Feminist Studies 22(2), 279-301. Rushforth, B. (2003). A little flesh we offer you: the origins of Indian slavery in New France. William and Mary Quarterly 60(4), 777-808.

Automatic Clothesline

Bulacan State University Sarmiento Campus â€Å"Automatic Clothesline† In partial fulfilment in research methodology Submitted by: Mark Cyrill R. Manzon BSIT-3B Submitted to: Mr. Pedro Abanador Instructor Submitted by: Mark Cyrill R. Manzon BSIT-3B Submitted to: Mr. Pedro Abanador Instructor CHAPTER I PROBLEM AND ITS BACKGROUND Introduction In today’s present era of the technology was evolved more household choirs was converted to a modern ways. It was a long time ago that the people use a lot of efforts and dedication for their works even there’s a way to lessen their task every day.Automated Clothesline gives more opportunities the client or the user to give a convenience on their daily tasks. In this case study, I intend to conduct an intensive research that would help the people and let them in modern technology. In today’s present era of technology, the mobile sector has seen some of the biggest and most amazing breakthroughs in the technology industr y in the last few decades. It was not long ago that the notion of having a handheld device to communicate with others and access data on the go was the whim of sci-fi fans. Not so anymore.The arrival of smartphones ushered in a new era of intelligent innovation and unparalleled connectivity. Mobile  code division multiple access  (CDMA) technology has evolved rapidly over the past few years. Since the start of this millennium, a standard mobile device has gone from being no more than a simple two-way  pager  to being a  mobile phone,  GPS navigation device, an embedded  web browser  and  instant messaging  client, and a  handheld game console. Many experts argue that the future of computer technology rests in  mobile computing  with  wireless networking (3G and 4G Networking).In this case study, I intend to conduct an intensive research that would hint the advantages of 3G and 4G networking in terms of mobile technology issue so that I would immensely stu dy about â€Å"Mobile technology†Ã‚  is the technology used for cellular communication. Mobile computing by way of tablet computers, cell phone is becoming more popular. Mobile technology is available on the 3G and 4G networks. Statement of the Problem General Problem: How does the mobile technology dominant and useful to operate the 3G and 4G Networks. Specific Problem: . How may mobile technology effectiveness be identified as: 2. 1 Portability to use in different places. 2. 2 Computer like abilities to store and retrieve files. 2. 3 Capability to access in internet. 2. 4 Price flexibility. 2. 5 Very useful apps for day to day routine. 2. What gigantic features 3G and 4G networks can provide to be dominant as: 3. 6 Wide variety of voice and data services. 3. 7 Operate on a core IP (Internet Protocol) network 3. 8 Ability to  support mobile rates of 100 Mbps, and fixed rates of 1Gbps. . 9   High-speed  packet  transmissions or burst traffic in the channels. 3. 10 Adv ancement of communication devices such (voice, text and video messaging). 3. 11 peer-to-peer  (P2P)  file sharing  applications Significance of the Study The importance of studying the 3G and 4G networking in mobile technology is how it promises to change the way users interact with resources and applications, moving services away from desktop and laptop computers and how would it be more suitable for the user in the coming year. Scope and LimitationThe purpose of the study is essentially in the development of the mobile technology and its 3G and 4G Networks. The same codes used in the  2G-3G  networks will be applied to future 4G mobile or wireless networks, the detection of very short bursts will be a serious problem due to their very poor partial correlation properties. Recent study has indicated that traditional multi-layer network architecture based on the  Open Systems Interconnection  (OSI) model may not be well suited for 4G mobile network, where transactions o f short packets will be the major part of the traffic in the channels.As the packets from different mobiles carry completely different channel characteristics, the receiver should execute all necessary  algorithms, such as channel estimation, interactions with all upper layers and so on, within a very short time to make the detections of each packet flawless and even to reduce the clutter of traffic. Method of the Study The respondent of the study will include programmer, developer, market analyst, mobile store owner, and mobile users. The study will be conducted from January to march 2013.

The Uw Madison School Of The Middle East, Asia, And Latin...

Because our nation is culturally diverse we must be prepared to teach the next generation of nurses to be culturally sensitive so they won’t alienate their patients, and risk making the patients worse off. To insure this goal we must change how the UW-Madison School of Nursing treats these non-europeans: people from various arts of the Middle-East, Asia, and Latin America. Without instruction in cross-cultural medicine medical practitioners make patients wary, through breaking taboos during the course of ones treatment. (Fadiman, 61) Cross-cultural medicine is an important area to expand because, as Fadiman noted, fifty percent of the US population growth has come from immigrants as of 1990. (Fadiman, 271) These immigrants which include many Middle-Easterners, Asians, and Latin Americans may discover our healthcare system is culturally insensitive. This could lead to lower rates of hospital expenditure, as well as lower morbidity within the US. In fact, if patients were to st op viewing hospitals as last resorts their would be less death, because it is these visits where patients most often die. (Fadiman, 63) Although, there has been a push to incorporate lessons in cross-cultural medicine into medical schools we must also teach cross-cultural medicine to nurse practitioners in order to increase hospital accessibility. (Fadiman, 271) One reason cross-cultural medicine would help these groups get better care is that by understanding the individual cultures the doctors