Tourism promotes understanding free essay sample

Can international tourism promotes understanding between nations? BY 611 loll Every year, hundreds of millions of people move around to see a different part of the world. It is natural to assume that tourists who have seen other countries have a better knowledge of the people. That assumption also leads to the conclusion that international tourism promotes understanding between nations. How true is this? Let us examine what tourists do in a different country.First, before going abroad, tourists are often told by their travel agents of the possible shards which sometimes include local people. They are given example of extreme cases where victims are always the travelers. Then, when they arrive, they are immediately taken to their hotels in big coaches. They flood places where local people dont go. Their shopping, meals, entertainment all take place in secluded areas. They wear a bubble all the way. Apart from speaking to the guide and a few shop assistants, tourists rarely talk to the local people. We will write a custom essay sample on Tourism promotes understanding or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page To make it even worse, they meet pickpockets, they are ripped off by dishonest traders. Furthermore, very few local people bother to talk to them out of a genuine Interest In the guests country, people and culture. Therefore, when asked how much they know about the local people, their answer Is very little. If someone really wants to understand a different culture, he has to learn Its language, stay there for at least a few month without wearing a bubble, learn how to curse and swear, bargain with a vegetable vendor and then he can say that he understands the people.

Origins of the ‘Lisp’ of Spain

Origins of the ‘Lisp’ of Spain If you study Spanish long enough, sooner or later youll hear a tale about Spanish King Ferdinand, who supposedly spoke with a lisp, causing Spaniards to imitate him in pronouncing the z and sometimes the c to be  pronounced with the th sound of thin. Oft-repeated Story Merely an Urban Legend In fact, some readers of this site have reported hearing the tale from their Spanish instructors. Its a great story, but its just that: a story. More precisely, its an urban legend, one of those stories that is repeated so often that people come to believe it. Like many other legends, it has enough truth- some Spaniards indeed do speak with something that the uninformed might call a lisp- to be believed, provided one doesnt examine the story too closely. In this case, looking at the story more closely would make one wonder why Spaniards dont also pronounce the letter s with a so-called lisp. Heres the Real Reason for the ‘Lisp’ One of the basic differences in pronunciation between most of Spain and most of Latin America is that the z is pronounced something like the English s in the West but like the unvoiced th of thin in Europe. The same is true of the c when it comes before an e or i. But the reason for difference has nothing to do with a long-ago king; the basic reason is the same as why U.S. residents pronounce many words differently than do their British counterparts. The fact is that all living languages evolve. And when one group of speakers is separated from another group, over time the two groups will part ways and develop their own peculiarities in pronunciation, grammar, and vocabulary. Just as English speakers talk differently in the U.S., Canada, Great Britain, Australia, and South Africa, among others, so do Spanish speakers vary among Spain and the Latin American countries. Even within one country, including Spain, youll hear regional variations in pronunciation. And thats all were talking about with the lisp. So what we have is not a lisp or an imitated lisp, just a difference in pronunciation. The pronunciation in Latin America is no more correct, nor less, than that in Spain. There isnt always a specific explanation of why language changes in the way it does. But there is a plausible explanation given for this change, according to a graduate student who wrote to this site after the publication of an earlier version of this article. Heres what he said: As a graduate student of the Spanish language and a Spaniard, being confronted with people who know the origin of the lisp found in most of Spain is one of my pet peeves. I have heard the lisping king story many times, even from cultured people who are native Spanish speakers, though you will not hear it come from a Spaniard. Firstly, the ceceo is not a lisp. A lisp is the mispronunciation of the sibilant s sound. In Castilian Spanish, the sibilant s sound exists and is represented by the letter s. The ceceo comes in to represent the sounds made by the letters z and c followed by i or e. In medieval Castilian there were two sounds that eventually evolved into the ceceo, the à § (the cedilla) as in plaà §a and the z as in dezir. The cedilla made a /ts/ sound and the z a /dz/ sound. This gives more insight into why those similar sounds may have evolved into the ceceo. Pronunciation Terminology In the above student comment, the term ceceo is used to refer to the pronunciation of the z (and of c before  e or i). To be precise, however, the term ceceo refers to how the s is pronounced, namely the same as the z of most of Spain- so that, for example, sinc would be pronounced like roughly think instead of like sink. In most regions, this pronunciation of the s is considered substandard. When used precisely, ceceo doesnt refer to the pronunciation of the z, ci or ce, although that error is often made. Other Regional Variations in Pronunciation Although differences in the pronunciation of the z (and sometimes c) are the most well-known of the geographical differences in Spanish pronunciation, they arent the only ones. Another well-known regional variation involves yeà ­smo, the tendency, common almost everywhere, for the ll and the y to share to share the same sound. Thus, in most areas, pollo (chicken) and poyo (a type of bench) are pronounced alike. But in parts of South America, the sound of the ll can be something like the s in measure, also called a zh sound. And sometimes the sound can be something like the j or sh of English. Other regional variations include the softening or disappearance of the s sound and a merging of the l and r sounds. The cause of all these variations is much as the same as for the regional variations in the z- isolation of some speakers can lead to diverging pronunciations. Key Takeaways Languages such as English and Spanish that cover wide geographical areas tend to develop regional differences in pronunciation.Such a natural change in regional pronunciation- and not a long-ago royal edict as is sometimes believed- is responsible for the z (and c before e or i) being pronounced differently in Latin America than in Spain.Those used to the Latin American pronunciation should not think of the pronunciation of Spain ans being inferior, or vice versa- differences exist, but neither type of Spanish is inherently better.

Social Solidarity through Pop Music Essay Example | Topics and Well Written Essays - 1250 words

Social Solidarity through Pop Music - Essay Example Of the many artists, Bob Dylan and John Lennon exemplified the experience and in fact Jimi Hendrix had an album titled "Are You Experienced". This expressive revolution brought an audience together through a common bond and satisfied the pop music listener's quest for solidarity. It is not too much to say that the 1960s were the root of the expressive revolution of sacred realism through music. Breaking traditional forms of folk music by combining folk music and rock music, Bob Dylan was one of the most influential artists of the era and together with the Beatles were able to ignite a pop music revolution. The music was powerful and was able to unite listeners into a 'collective consciousness" by just appreciating their music together. Strangers passing on the street would be drawn together as friends by the acknowledgment of a familiar song. This collective solidarity gave the listener authenticity as well as a verification of a meaningful existence. This justification for one's life became the sacred authenticity that a generation was in search of. Breaking the mold and blending new styles opened the gates for listeners to detach from the tired past and experiment with their own identity. For Bob Dylan, unlike many artists who pursue only one style of music, Dylan did not stick with one genre. His music can be divided into many different genres such as folk, folk-rock, gospel, and country. Dylan's early music was inspired by a famous folk singer, Woody Guthrie, who had a great influence on the young Dylan. In a Los Angeles Times interview, Dylan said, "Woody's songs were about everything at the same time. They were about rich and poor, black and white, the highs and lows of life, the contradictions between what they were teaching in school and what was really happening" (Hilburn 2004). This indicated Dylan's understanding that integration meant collective. We were all one in search of a common medium. Dylan expressed current social issues through his lyrics as opposed to many traditional folk singers' upper class oriented musi c. His music was well blended with traditional instrumentation such as acoustic guitar, and harmonica. In addition, Dylan broke the stereotypical ideology that folk music cannot exist without its traditional form. By 'going electric' at the Newport Folk Festival, Dylan defied the norm and explored a revolutionary act that was widely criticized as a commercial sell out. However, Dylan had opened the door to his own identity and had invited millions of listeners to join him. Those that had been categorized for decades were free to become a part of the new consciousness. As Eyerman and Jamison contend, "The musician, songwriter, or composer must first learn the notation and the melodic and rhythmic procedures of the tradition in order to make music; otherwise it could not be passed on. But, at the same time, artistic creation requires that those rules be broken, or at least amended, so that the tradition can be rejuvenated by adding something new to it" (29). Dylan was able combine our cultures in a way that gave us an unspoken agreement and a silent bond that would soon become sacred. This bond would become a large part of our new identity. In his Los Angeles Times

Violence In Televison Essay Example | Topics and Well Written Essays - 2250 words

Violence In Televison - Essay Example Moreover, children in society tend to emulate whatever they see on television as a means of living their life for example, with superhero movies there have been so many cases of children trying to imitate superhero powers and jumping off buildings in an attempt to fly. Violence refers to extreme aggression being executed by physical or mental force and occurs when a person gets very angry and is not able to control his anger and is depicted a great deal on television. Due to the same, it does have an impact on society and contributes to violence in society in many ways. (F, Seymour, and Robert D. Singer) 1: Therefore, the following questions is posed; does violence shown on television in the form of television shows, movies and even advertisement have an impact on the minds of both adults and children and subsequently contribute to violence in society? Television programs today have an array of subjects ranging from criminal activities to investigative shows where crimes being commit ted in neighbourhoods, among families and even on a global scale are depicted and appeal to viewers the most. (Henrey J Kaiser Foundation) From the point of view of the channel or the directors of the show, such shows are mostly in the form of thrillers and suspense which tend to arouse a great deal of interest in the minds of the audience and are thus good for increasing the ratings. However, these shows depict a great deal of violence, which is harmful for audience of all ages to watch. Moreover, the shows may also have explicit violent content which may scar the minds of people. The shows easily portray scheming, violent physical activity, criminal activities such as theft and murder and thrive on these subjects where the criminals are normal people living ‘normal’ lives by the day and committing such activities by night. This obviously has a very negative impact on the audience. These shows that display such explicit violent content tend to get ingrained in the mind s of the viewers as they begin to use the language as used in the show, however offensive it might be and tend to act in the same manner as the actors on the show in similar situations. (Anderson, Kerby) For example, if on the show a man becomes violent and aggressive in a petty issue like parking his car or talking to the traffic police, people watching the show tend to use the same angst while dealing with a similar daily situation because they feel that using aggression will get them what they want which may be equal to what treatment the actor got on the television show. (Huesmann, L.R, and J. Podolski) Moreover, if children tend to view these television series and shows the effect is even worse on them because they are at a stage in their lives where their minds are still growing and developing and they are gullible towards all kinds of situations. Many parents and older people do not think twice before letting their children sit with them and view television serials that might not be suitable for them. Violence being shown on television thus gets imprinted on their minds and this violence tends to come out in society when they deal with similar situations. 2: Are children affected worse by violence shown on television as compared to adults? Children, more than adults, are not able

Crime Control Essay Example for Free

Crime Control Essay Crime has become as multifaceted as human nature, impinging on communities and threatening human rights and freedoms. Has the impact of criminal activity become extremely intense, that we as society members have strayed away from honesty and justice? Are individuals no longer valuing integrity and fairness? Criminal justice organizations both public and private sectors goals are to reduce crime within the communities and regain the trust and confidence in a fair and just system for law-abiding citizens. In the process of achieving a fair and just society, due process and crime control tactics must adhere to the ethical dimensions of the criminal justice system. I am prepared to introduce a synopsis that highlights key ethical issues in the justice system that is directly affected by ethical motives. Honesty versus Justice within the Communities Trust is a factor that is lacking within the communities, and the question in mind is how will the criminal justice organization rehabilitate the issue and let justice prevail. Justice is often defined as fairness or the suitable rewards or retribution. Justice focuses more on a person’s rights more than the needs of an individual. So how can justice prevail if community members are fighting against law enforcement, and honesty among officers and the community is obsolete? In many cases, even when people notice a crime, they often turn the other way. According to NPR (2010), â€Å"Witnesses to crimes involving things like gang activities can often be scared away from giving information to police. It does not help that a stop snitching philosophy has been promoted by some hip-hop artists and many urban communities† (para 2). After past incidents of bad treatment by the outside world and law enforcement, it has become a mainstream thought in many minority communities law enforcement is not to be trusted. And if the community cannot trust police officials, the people in the community will not step forward and be honest and aid in the investigations. Police Departments are committed to working with the communities to recognize and resolve community problems. There are departments of employees dedicated to working collectively through an assortment of programs. These programs and services are created in hope that trust and justice will be incorporated back into the community and law enforcement agencies will be able to optimistically impact the community’s quality of life as well as highlight the strengths of neighborhoods. Due Process and Crime Control Tactics Law enforcement has integrated strategies into the communities to prevent and solve crimes that are affecting citizen’s quality of life. Crimes such as theft, burglary, and vandalism are a few areas law enforcement has turned their focus on. Local law enforcement organizations will have to become accustomed to existing policing programs to fulfill the requirements of security. The goal of due process and crime control is to enhance the effectiveness of the community. When the community trusts and believes in the justice field, community members will be more prone to assisting law enforcement. Due process ensures the law is being incorporated in the tactics to prevent and stop criminal acts. Another way for law enforcement to gain the trust and respect of the community is to offer up incentives that demonstrates community enhancements. increased involvement from groups in public decision making increases access to material resources and financial opportunities for underprivileged groups changes in public policy to achieve greater and meet the needs of diverse groups increases in suitable, available community services and common interest groups developing more early childhood and youth programs within the communities Law enforcement organizations have sought to investigate the causes of crime within the communities and lower the level from the hearts of the people being affected by criminal acts. Through the construction of successful joint venture with the community and public and private sectors problem solving procedures are being implemented and ethical standards and being followed. In the awaken of September 11th incident, law enforcement agencies discover that they are understanding that it is important to identify the responsibilities and create goals goals that will reduce crime within the communities and regain the trust and confidence in a fair and just system for law-abiding citizens. According to Lane Henry 2010, ‘People argue for longer term strategies aimed at dealing with the political, social, economic and cultural factors associated with crime. In doing so, we explore the potential of community development to contribute to crime prevention, particularly community or street crime and violence. Theoretical and practice intersections between community development and certain crime prevention approaches are identified notably those which link crime and violence with dis-empowerment, poverty, inequality, exclusion, the learning of violence within families and communities, and lack of opportunity for children and young people to develop their potential† (para 1). Conclusion Crime has become as multifaceted as human nature, impinging on communities and threatening human rights and freedoms. The impact of criminal activity has become extremely intense, that we as society members have strayed away from honesty and justice. Law enforcement agencies are working extremely hard to rebuild the union that has been broken. Individuals are no longer valuing integrity and fairness, but with the support from law enforcement, trust will be regained and community members will be more prone to step up and offer assistance. Criminal justice organizations both public and private sectors goals are to reduce crime within the communities and recover the trust and confidence in a fair and just system for law-abiding citizens. In the process of achieving a fair and just society, due process and crime control tactics must adhere to the ethical dimensions of the criminal justice system. I have identified ethical issues in the justice system that is directly affected by ethical motives and come to the conclusion that dedication from both parties is the answer to rebuilding a broken society.

Use of Humor in Erdrichs Tracks Essay -- Erdrich Tracks

Use of Humor in Erdrich's Tracks  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚   An old adage claims that laughter is the best medicine to cure human ailments.   Although this treatment might sound somewhat unorthodox, its value as a remedy can be traced back to ancient times when Hypocrites, in his medical treatise, stressed the importance of   â€Å"a gay and cheerful mood on the part of the physician and patient fighting disease† (Bakhtin 67).   Aristotle viewed laughter as man’s quintessential privilege:   â€Å"Of all living creatures only man is endowed with laughter† (Bakhtin 68).   In the Middle Ages, laughter was an integral part of folk culture.   â€Å"Carnival festivities and the comic spectacles and ritual connected with them had an important place in the life of medieval man† (Bakhtin 5).   During the trauma and devastation of German bombing raids on London during World War II, the stubborn resilience of British humor emerged to sustain the spirit of the people and the courage of the nation.   To laugh, even in the face of death, is a compelling force in the human condition.   Humor, then, has a profound impact on the way human beings experience life.   In Louise Erdrich’s novel Tracks, humor provides powerful medicine as the Chippewa tribe struggles for their physical, spiritual, and cultural survival at the beginning of the twentieth century.   While the ability to approach life with a sense of humor is not unique to any one society, it is an intrinsic quality of Native American life.   â€Å"There is, and always has been, humor among Indians . . . † (Lincoln 22).  Ã‚   In deference to their history, this can best be described as survival humor, one which â€Å"transcends the void, questions fatalism, and outlasts suffering† (Lincoln 45).   Through their capacity to draw common... ...emain the contrary powers of Indian humor† (Lincoln 5).   For the Chippewa, this humor provides powerful medicine for the physical, cultural, and spiritual preservation of their tribe.  Ã‚        Works Cited   Bakhtin, Mikhail.   Rabelais and His World.   Bloomington:   Indiana UP, 1984.   Erdrich Louise.   Tracks.   New York:   Harper Collins, 1988.   Ghezzi, Ridie Wilson.   â€Å"Nanabush Stories from the Ojibwe.†Ã‚   Coming to Light.   Ed. Brian Swann.   1st ed.   New York:   Random House, 1994.   Lincoln, Kenneth.   Indi’n Humor.   New York:   Oxford UP, 1993.   Sergi, Jennifer.   â€Å"Storytelling:   Tradition and Preservation in Louise Erdrich’s Tracks.†Ã‚   World Literature Today   66   (Spring 1992):   279-282.   Towers, Margie.   â€Å"Continuity and Connection:   Characters in Louise Erdrich’s Fiction.†Ã‚   American Indian Culture and Research Journal   16   (1992):   99-115.     

Health Dissertation ideas †Applied Musculoskeletal Podiatry

Introduction Pathology that causes metatarsalgia Morton’s Neuroma can be described as a perineural fibrosis and nerve compression of the common digital nerve. This condition often occurs in the second and third intermetatarsal spaces, although it can be seen in other intermetatarsal spaces (Pace, Scammell and Dhar, 2010). According to Adams (2010) neuroma may be bilateral, are more prevalent in female adults starting their third decade of life. Whilst the actual cause of Morton’s neuroma is not clear, it is believed to be associated with hypermobility of the metatarsals, in addition to repetitive motions which ultimately grind nerves in metatarsals. There are suggestions from anecdotal studies that Morton’s neuroma is directly linked to crush injuries or repetitive running or jumping motions. The results of such repetitive actions may lead to damage or injury on the area of the forefoot. There is also the possibility of structural misalignment and mechanical abnormalities that may be experienced at the forefoot, which may consequently lead to creation of symptomatic Morton’s neuroma (Pace, Scammell and Dhar, 2010). Structural misalignment in this case may refer to lateral compression of foot, which can lead to invariable pain when inflamed bursa is squeezed between the metatarsal heads. Hauser (2011) observes that one of the most common structural concerns is the possibility that lax in intermetatarsal ligament may cause inter-digital nerve tissue to shift into a wrong place, particularly in between the areas of metatarsal heads and be subject to comprehensive trauma. The common subjective history based on patients’ reports is usually characterised by numbness and tingling, and radiating and burning pain. Patients’ reports also suggest that the pain is localised at the plantar aspect of the specific intermetatarsal space, although it can also extend itself and radiate into other adjacent toes of the infected person (Berry, Gonzalez, Bowman, 2012). Patients often describe their feeling of â€Å"lump† on the foot’s bottom. Significantly, these symptoms may rise when the infected carries out a weight-bearing activity. Reports indicate that closed-toed shoes, particularly the tight-fitting ones can lead to increase in symptoms, and patients report relief after they remove or change their shoes (Summers, 2010). Relief may also be experienced when the patient massages their foot or moves the toes around. Aetiology of this condition and how it would be recognised clinically Research has established that Morton’s neuroma is unique in terms of clinical diagnostic requirements or needs (Drury, 2011). This is because although patients frequently report symptoms such as numbness, there is evidence that sensory deficit may or may not be found when the patient goes through examination. Drury (2011) observes that there may be a demonstration of splaying or divergence of the digits when clinical presentation is carried out, and that more often than not little or no edema or inflammation can be observed clinically. Typically, reproducing pain with palpation to the intermetatarsal space is a normal activity, but care must be taken to put the pressure in the space, and avoid the metatarsal heads. There have been various clinical strategies to assist clinicians effectively diagnose Morton’s neuroma. Schreiber et al (2011); Faraj and Hosur (2010) report that patients may demonstrate a Mulder’s sign, which is provoked by squeezing the forefoot and conducting application of plantar and dorsal pressure. In other words, clinical test for Morton’s neuroma has all along been to compress the foot by applying pressure to the medical and lateral aspects of the foot at the metatarsophangeal joints, which in turn puts pressure on nerves (Pastides, El-Sallakh and Charalambides, 2010: 503). A positive clinical test outcome involves a pop or click that can be felt and heard at the same time. This pop or click is usually painful to the patient. There is a possibility of replicating symptoms of Morton’s neuroma in a process involving Gauthier’ test, where the forefoot is squeezed and medial to lateral pressure is applied (Beltran et al., 2010). Mayo Clinic (2010) has subsequently described a test consisting of hyperextending the toes and rolling the thumb of the examiner in the area of symptoms, a process that may identify a tender, thickened, and longitudinal mass of flesh. Clinical findings also indicate that Morton’s neuroma may also show Tinel’s sign as well as Valleix phenomenon (Berry, Gonzalez and Bowman, 2012). The other pathway for detecting Morton’s neuroma is diagnostic testing. This process involves plain radiography, ultrasound, and magnetic resonance imaging (Summers, 2010). Radiographs are routinely ordered to rule out musculoskeletal pathology, even though rise in proximity of the adjacent metatarsal heads is believed to result in increased pressure of the intermetatarsal nerve. Furthermore, Hause (2010) found no significant correlation between radiographic findings and the clinical presence of neuromas. In addition, there is the recommendation to use ultrasound in the diagnostic evaluation of the interspaces (Hause, 2010). Drury (2011: 19) observes that there is a likelihood of a neuroma appearing as an ovoid mass with hypoechoic signal-mass to the long axis of the metatarsals. . Adams (2010), however, advises that although MRI is a useful diagnostic tool, it should always be reserved for atypical presentations or to eliminate multiple neuromas. Significantly, neuroma can be best identified on T1 weighted images, and it’s likely to come out as a well-demarcated mass with minimal signal intensity. In summary, clinical diagnostic approach to identify Morton’s neuroma can be achieved by ensuring that examination and diagnostic testing has ruled out any other etiologies of symptoms. Conservative treatment intervention for Morton’s neuroma No best treatment interventions have been identified in the literature for treatment of Morton’s neuroma. Conservative intervention for Morton’s neuroma is considered to be one of the best treatments alternatives for the condition. However, some of the common conservative treatment options involve changing shoe type, use of metatarsal pads, and use of non-steroidal anti-inflammatory drugs, administering sclerosing alcohol injections, and surgically transposing the offending nerve (Summers, 2010). Many doctors and physical therapists have recommended that patients are put to rest for a specific period of time, and reduce activities that may elicit pain (Pastides, El-Sallakh and Charalambides, 2012). Injections as an intervention Various clinical studies have exposed the need to consider injection as a better treatment option for Morton’s neuroma over other non-surgical treatment options available. In a study conducted by Drury (2010) different conservative treatment measures often produce similar results. In a small randomised prospective study of 23 patients, the researchers compared reduction in neuroma pain when supinatory or pronatory insoles are used. In the study, there was no explicit inclusion or exclusion criteria other than clinical diagnosis, and no participant or evaluator was considered blind to the intervention allocations. The study had 13 percent of the participants (two patients) drop out after one month into the experiment. After 12 months, pain in the supination and pronation insole groups reduced by 50 percent and 45 percent, respectively- a reduction considered insignificant. In another study, a physically active 25-year-old female with diagnosed symptomatic Morton’s neuroma was put through a massage therapy sessions. The six-session massage therapy involved a 60-75 minute weekly massage exercise involving postural alignment in addition to localised foot and leg treatment. The patient was also put to complete at-home daily exercise, with a weekly monitoring of change by the therapist who reassessed the patient’s posture and ensuring the client fills out a pain survey based on a Visual Analog Scale. The results indicated progressive change on the side of the client in terms of pain character. Specific patient report indicates that the pain character changed from burning and stabbing to dull and pulsing sensation after three sessions. There was also a reduction in pain during exercise. Although this study suggests that massage therapy is a significant treatment for Morton’s neuroma, its weakness is based on the fact that the treatment only involved one client. No study has indicated the effectiveness of the method on a larger randomised control studies. In a prospective randomised study involving 82 patients, the researchers compared steroid injections alone based on shoe modifications (Berry, Gonzalez and Bowman 2012). Some of the recorded primary outcomes were patient satisfaction, which is basically the presence or absence of pain, the pain intensity, and return of pain afterwards. The results of the study indicated that steroid injections yielded better outcome in terms of patient satisfaction, compared with other conservative options such as shoe modifications alone. In this study, 23 percent of shoe-modification patients achieved complete satisfaction after one month of intervention. This was significantly lower than the 50 percent of patients who experienced significant pain reduction after one month of steroid injection. After six months, 28.6 percent of the participants experienced satisfaction with shoe modification, significantly lower than 73.5 percent satisfaction amongst those who had received injection. Although the difference was significant lower after one year with 63 percent satisfaction with shoe modification and 82 percent with injection, the reduction could have occurred because patients were allowed to cross over after six months. The researchers observed that no complications were reported, although the study was limited by a high cross-over rate from shoe modification group to injection group after 6moths. Some studies have investigated other techniques such as the use of sclerosing effects of alcohol (Pastides, El-Sallakh and Charalambides, 2012; Schreiber, 2011; Beltran, 2010; Pace, Scammell and Dhar, 2010), where delivery is done by multiple injections guided by ultrasound techniques over time. Improvements were reported in term of clients’ satisfaction with no long-term adverse effects in various case series. It is mostly recommended that even as an injection is used as the chosen treatment option, other supplementary management options such as shoe adjustments and calf-stretching exercises should also be implemented concurrently. However, in case the conservative interventions fail to work, many patients may be advised to undergo surgery to remove the neuroma or just to release pressure from ligaments. Studies have, however, indicated that 15 to 20 percent of these surgeries will not relieve the patient from pain, and may also lead to various complications such as local post-surgery infections, scar tissue, and damage of soft tissues which may affect normal foot functions. It has also been established that there is a possibility of neuroma recurring after the surgery. Conclusion Whilst the exact cause of Morton’s neuroma is not known, the common belief is that it is caused by hypermobility of the metatarsals. This may also be aggravated by repetitive motions involving grinding of nerve bundle. The common symptoms are patients describing their feeling of â€Å"lump† on the foot’s bottom. These symptoms may increase when the patient engages in weight-bearing activity. Research has established that symptoms that may be associated with Morton’s neuroma may not necessarily mean a person is suffering from the complication. This is why clinical diagnosis is often recommended. One of the most common clinical strategies that may be beneficial to clinicians diagnosing Morton’s neuroma is patients demonstrating Mulder’s sign. A positive clinical test outcome involves a pop or click that can be felt and heard at the same time. Clinical findings also indicate that Morton’s neuroma may also show Tinel’s sign as well as Valleix phenomenon (Berry, Gonzalez and Bowman, 2012). Although there are various conservative therapies used to manage Morton’s neuroma complications including rest, weight loss, and exercise for muscle strengthening, orthotics, massage therapy, physiotherapy, and manipulation, these methods are found to be very effective. It’s against this backdrop that injection is found to be a more effective way of managing the complication as reported by clients’ satisfaction studies. Injection may involve steroid injection, local anaesthetic injections or sclerosant injections. Injections have been found to yield better outcome in terms of patient satisfaction, compared with other conservative options such as shoe modifications alone. It has also been established that there are no complications reported in injections. Medical practitioners, however, recommend that patients may be advised to undergo surgical intervention in case conservative interventions fail to yield desired results. References Adams WR. (2010). Morton’s neuroma. Clin Podiatr Med Surg., (2)7: 535-545. Beltran LS, Bencardino J, Ghazikhanian V, Beltran J. (2010). Entrapment neuropathies III; lower limb. Semin Musculoskelet Radiol, 14: 501-111. Berry K, Gonzalez P, and Bowman RG. (2012). Physical Medicine and Treatment for Morton Neuroma. Available from: http://emedicine.medscape.com/article/308284-overview [Accessed November 17, 2014.]. Bronfort G, Haas M, Evans R, et al. (2010). Effectiveness of manual therapies: the UK evidence report, Chiropractic & Osteopathy, 18(3):1–33 Drury AL. (2011). Use of homeopathic injection therapy in treatment of Morton’s neuroma. Altern Ther Health Med, 2(1) 17-48. Faraj A, and Hosur A. (2010). The outcomes after using two different approaches for excision of Morton’s neuroma. Chinese Medical Journal, 12 (3): 2195- 2198. Hauser R. (2011). A retrospective observational study on Hackett-Hemwall dextrose prolotherapy for unresolved foot and toe pain at an outpatient charity clinical in rural Illinois. J of Prolotherapy 2 (3): 543-551. Mayo Clinic. (2010). Morton’s Neuroma. [Accessed September 16, 2010]. Available from: http://www.mayoclinic.com/health/mortons-neuroma/DS00468. Published & Updated October 5, 2010. Pastides P, El-Sallakh S, Charalambides C. (2012) Morton’s neuroma: A clinical versus radiological diagnosis. Foot Ankle Surg, 18: 22-4. Pace A, Scammell B, Dhar S. (2010). The outcome of Morton’s neurectomy in the treatment of metatarsalgia. Int Orthop, 3 (4):511-5. Schreiber K, Khodaee M, Poddar S, Tweed EM. (2011). Clinical Inquiry. What is the best way to treat Morton’s neuromaInt Orthop, 60: 157-158. Summers A. (2010). Diagnosis and treatment of Morton’s neuroma. Emerg Nurse, 1(8): 16-17.