Deep Transverse Frictions Tissue Injuries Health And Social Care Essay

Deep Transverse Frictions Tissue Injuries Health And Social Care Essay The purpose of this essay is to consider the merits of deep transverse frictions in the treatment of acute and chronic soft tissue injuries. To facilitate this I have considered a wide range of research that has been conducted into the use of frictions. I have also considered the use of alternative therapies in the treatment of similar conditions in order to evaluate the effectiveness of deep transverse frictions in comparison to each of the other treatment methods. What is deep transverse friction? Deep transverse friction was developed for the treatment of soft tissue lesions by the British osteopath Dr. James Cyriax who postulates that deep transverse friction is effective in the reduction of fibrosis and facilitates the formation of strong, pliable scar tissue at the site of healing injuries. Deep transverse friction, which is also known as cross-fibre frictioning (CFF), can help to alleviate build up of the crystalline deposits that can form between tendons and their sheaths and result in painful tendonitis. It can also help to offset the development of myofascial adhesions and soften those that are already present. Deep transverse frictions should be administered with a braced finger or thumb moving across the grain of the muscle, tendon or ligament with a deep, non-gliding, friction stroke. It is not necessary to use a lubricant as this reduces friction. The therapists thumb and the clients skin should move as one over the exact site of the lesion to create a mechanical effect on the tissue being treated. The massage must be applied directly over the site of the lesion and at right angles to the fibres, the stroke must also be wide enough to divide the fibres without skipping over them. The treatment can be painful, but should always be conducted within the pain tolerance threshold of the recipient, and should be started only with the informed consent of the client. It is contraindicated during the initial inflammatory stage of an acute injury. Deep transverse friction may be utilised in the treatment of both acute and chronic conditions. Its uses include; à ¢Ã¢â€š ¬Ã‚ ¢ mobilisation of interstial fluid à ¢Ã¢â€š ¬Ã‚ ¢ reduction or modification of oedema à ¢Ã¢â€š ¬Ã‚ ¢ increase of local blood flow à ¢Ã¢â€š ¬Ã‚ ¢ decrease of muscle soreness and stiffness à ¢Ã¢â€š ¬Ã‚ ¢ moderation of pain à ¢Ã¢â€š ¬Ã‚ ¢ facilitation of relaxation à ¢Ã¢â€š ¬Ã‚ ¢ prevention or elimination of adhesions (Wieting 2004). There are a variety of massage techniques that can have physiological, neurological and psychological effects. These can be used to reduce pain and the formation of adhesion, mobilise fluids, increase muscular relaxation, and increase vasodilatation (Wieting 2004). Mechanical pressure on soft tissues displaces fluid which then moves in the direction of least resistance. Movement of the practitioners hand creates a pressure gradient resulting in small amounts of fluid leaving the soft tissues and entering the venous or lymphatic systems, improving lymphatic flow (Wieting 2004). In addition to its mechanical effects, deep transverse friction (and other massage techniques) causes the release of histamine which has a superficial vasodilatory effect that assists in the washing out of metabolic waste products. A noticeable decrease in lactate occurs in massaged muscles which can be associated with reduced muscle spasm, increased endurance and force of contraction. (Cox, 2007) Other beneficial effects of massage include decreased blood viscosity and increased hematocrit levels. There is also an increase in circulating fibrinolytic compounds along with substances such as myoglobin, creatine kinase, dehydrogenase, and glutamic oxaloacetic transaminase which probably represent local muscle cell leakage from the applied pressure. There is also release of endorphins and enkaphalin production (Wieting 2004). Impulses from the stimulation of superficial skeletal muscle fibres, cutaneous and spindle receptors reach the spinal cord and may produce segmental moderation and even somatovisceral reflex changes (Wieting 2004). The normal healing process may also be improved by the breaking of cross bridges, which will help to prevent abnormal scarring. The mechanical action of the technique causes hyperaemia and increased blood flow to the area (Brosseau et al 2002). In addition shearing stresses are created at tissue interfaces below the skin. e.g.dermis-fascia, fascia-muscle, muscle-bone interfaces, the deep pressure prevents shearing of superficial tissues and the shear force is directed at the deeper tissue surface interface (Wieting 2004). This helps release underlying adhesions and promotes improved circulation to the area (Lorenzo 2004). Sevier and Wilson (1999) describe vigorous cross friction massage for 5-10 minutes over the common extensor tendon perpendicular to underlying soft tissue structures in the treatment of lateral epicondylitis. Point friction may also be performed directly over the lateral eipcondyle and over the radial tunnel where it can be used in an attempt to reduce venous congestion at the extensor carpi radialis origin. This is a purely descriptive article of commonly used treatments for tennis elbow. No analysis of any evidence regarding the efficacy of any of these treatments is given. Disabella (2004) describes the use of friction massage in conjunction with ultrasound and/or electrical stimulation in the treatment of elbow and forearm overuse injuries. In a systematic review of the use of deep transverse friction massage in the treatment of tendonitis Brosseau et al (2002) found only 2 randomised controlled trials of sufficient quality. One of which looked at patients receiving treatment for iliotibial band friction syndrome and the other at tennis elbow. The outcomes of both studies suggest that transverse friction massage combined with other physiotherapy modalities does not significantly reduce tendonitis symptoms when compared to a control. However these studies were of small sample size making it difficult to draw conclusions regarding the benefits or not of treatment of iliotibial band friction syndrome or tennis elbow with transverse friction massage. The tennis elbow study looked at 9 sessions of transverse friction massage given over 5 weeks in combination with other physiotherapy modalities and in isolation. The comparison groups were as follows; à ¢Ã¢â€š ¬Ã‚ ¢ deep transverse friction massage with therapeutic ultrasound and placebo ointment compared with therapeutic ultrasound and placebo ointment à ¢Ã¢â€š ¬Ã‚ ¢ deep transverse friction massage compared with phonophoresis alone No difference was found in pain relief, grip strength and functional status between the groups. This study used double blinding and a sound randomisation procedure but did not report withdrawals and dropouts (Brosseau et al 2002). Another study of lateral epicondylitis was carried out by Smidt et al (2002). 185 patients with lateral epicondylitis of at least 6 weeks were randomised using computer generated block randomisation to 6 weeks of treatment with steroid injection, physiotherapy or wait and see policy. The physiotherapy arm of the study consisted of 9 sessions of pulsed ultrasound, deep friction massage and an exercise program over 6 weeks. Outcome measures were general improvement, severity of main complaint, elbow disability, grip strength and pressure pain threshold. Prior to the main study a reproducibility study on 50 patients was carried out that demonstrated good intertester reliability for the research physiotherapists carrying out the outcome measures. Intention to treat analysis was used and at 6 weeks injection was significantly better than all other options on all outcome measures. There was a high recurrence rate in the injection group. The physiotherapy package (which included frictions) gave better long term outcomes than injection but was no better than wait and see policy. Interestingly the wait and see policy had better long term outcomes than injection and physiotherapy that included transverse friction. In a review article containing a summary of the evidence for the effectiveness of interventions for the management of tennis elbow Nimgade et. al (2005) used the Cochrane Collaboration guidelines to assess the quality of the evidence reviewed. The Cochrane guidelines have 11 score items for internal validity, 6 for external validity and 2 for statistical criteria. Thirty studies were reviewed and the quality scores awarded to each study varied between 2 and 9 (out of a possible 11). Eighteen of the studies scored between 6 and 11 points giving an indication of good quality. It appears that relative rest will eventually improve function but the use of early active interventions including steroid injection and physiotherapy modalities may speed up recovery. The physiotherapy interventions reviewed included exercise and ultrasound alone and in combination with friction massage. These authors concluded that, patients who need a rapid return to work or usual activities, may benefit from one or two steroid injections for pain relief in the first few weeks or months and physiotherapy (which may include friction massage) at any stage. Smidt et al (2003) carried out a review to evaluate physiotherapy interventions for lateral epicondylitis. This was a well conducted review that found only one RCT with acceptable validity showing exercises were significantly better than ultrasound plus friction massage. The authors therefore concluded there was insufficient evidence for the effectiveness for most interventions and there was weak evidence that ultrasound may have a beneficial effect. For the treatment of sub acute bicipital tendonitis Gonzalez (2004) recommended physical therapy involving soft tissue therapy with transverse gliding of the tendon and cross-friction massage. In the trial reviewed by Brosseeau et al (2002) involving patients with iliotibial band friction syndrome deep transverse friction massage was used in combination with rest, ice, stretching exercises and ultrasound and this was compared to a control group receiving rest, ice, stretching exercises and ultrasound only. No statistically significant difference was demonstrated in pain relief after 4 sessions of friction massage combined with the other modalities. There was however a clinically important difference in pain when running. This study was not double blinded but this is difficult to do where rehabilitation interventions are concerned and can result in trials of such modalities having consistently low methodological scores. However withdrawals and dropouts were reported which is good practice but there were problems with the randomisation procedure (Brosseau et al 2002). In a summary of aetiology, pathology and treatment of temporomandibular joint syndrome Berman (2004) suggest friction massage may help inactivate trigger points due to temporary ischemia and resultant hyperaemia produced by a firm cutaneous pressure. In addition small fibrous adhesions in the muscle formed as a result of surgery, injury, or prolonged restricted motion may be disrupted. Many studies have used subjective and non validated scales for pain measurement and the use of combined treatments causes difficulties when trying to evaluate treatment efficacy (Brosseau et al 2002). This can make comparison of outcomes between different trials particularly difficult. In studies where a lack of effect is demonstrated there are a number of variables that can contribute to this. These include characteristics of therapeutic application (experience of therapist, rate, rhythm and depth of technique application), population (age, sex, occupation, sports), disease (acute/chronic) and methodology (blinding, randomisation, validated outcome measures, sample sizes, comparison groups, massage only group to assess specific effects) (Brosseau et al 2002). Comments Conclusions Despite a lack of good quality evidence to recommend either its inclusion or exclusion transverse friction massage is a widely taught, and used, physiotherapy treatment in the management of muscle, ligament, tendon injury and pain. The majority of the literature found seems to review the usage of transverse friction massage in the treatment of tennis elbow. There is a lack of good quality, randomised, controlled trials testing the efficacy of transverse friction massage either in isolation or as part of management package. Many papers are descriptive in nature of transverse friction massage being used in conjunction with other modalities. The literature regarding mechanical, physiological, neurological effects and possible mechanisms of action is speculative which could be due to such trials being difficult to conduct.

The Strange Case of Dr. Jekyll and Mr. Hyde Essay -- Robert Louis Stev

The Strange Case of Dr. Jekyll and Mr. Hyde The Strange Case of Dr. Jekyll and Mr. Hyde, written by Robert Louis Stevenson, is a story rife with the imagery of a troubled psyche. Admittedly taken largely from Stevenson’s dreams, it undoubtably sheds light on the author’s own hidden fears and desires. Written at the turn of the 19th Century, it also reflects the psychology of society in general at the same time when Sigmund Freud was setting about to do the same thing. While Freud is often criticized for his seemingly excessive emphasis on sexual suppression as the leading cause of psychological disturbances, the time period in which he lived was exceedingly strict on what constituted appropriate and inappropriate behavior. Accordingly, Freud hypothesized that the majority of people were obliged to hide their unacceptable thoughts and feelings down in the depths of their unconscious from whence they would inevitably escape from at a later time to manifest in a variety of ways. The Strange Case of Dr. Jekyll and Mr. Hyde illustrates Freud’s theory of repression throughout the entirety of the story and shows the negative consequences associated with this coping strategy. Henry Jekyll is the character who has repressed the most and who consequently suffers the direst of outcomes. In his statement of his experiences leading up to the emergence of Edward Hyde, one anticipates the revelation of some early trauma of a fairly significant scale that would clarify the man’s need to regress to an alternate identity. However, Jekyll’s letter is free from any mention of anything of the sort. He instead emphasizes his â€Å"gaiety of disposition†, and his â€Å"guarantee† of a â€Å"distinguished future,† while steering clear of any descriptio... ...he reveals his struggle as he â€Å"sought with tears and prayers to smother down the crowd of hideous images and sounds with which my memory swarmed against me† (57). His fight with repression was a losing battle as was everyone else’s. They made the mistake of believing that an issue can be buried deep enough in the unconscious to remain hidden forever. Had Freud’s theories been made public a few years earlier they may have realized the irrationality of their actions and that openly addressing troubling material is the only way to resolve it. For as the Strange Case of Dr. Jekyll and Mr. Hyde makes disturbingly clear, small problems can grow into catastrophic ones when they finally break the surface, and they inevitably will as the fog cannot hold forever. Works Cited Stevenson, Robert Louis. Strange Case of Dr. Jekyll and Mr. Hyde. New York: Norton, 2003.

Integrating sustainability Essay

During the recent years many challenges have started facing communities due to the controversial tendencies in the modern world- rapid urbanization and struggles of communities for keeping environment in the state which was common for it for many centuries. The problem which communities have come across now is very complex, and requires a very well-considered approach. On one hand, the present generation wants to enjoy all the benefits of the time and take advantages of everything what it offers to them. On the other hand, it’s important to maintain to the environment in such a way that future generations can take advantage of it as well. It’s impossible to use all of the natural resources in just recent years because further generations will not be able to use them. Therefore, issues of sustainability have become particularly sharp lately. One of the ways to face the challenge and devote necessary attention to sustainability issues is by carrying out well-balanced policy on the government level, defining the mission statement of the policy, setting correct objectives, analyzing the present state of environment and factors influencing it, and suggesting measures which can be used in order to implement the adopted strategies. The major role of strategic planning in this matter cannot be doubted. The strategy has to be carried out at the highest level in order to meet all of the goals which nowadays reality sets in front of us. In Sutherland Shire, the damage of land is connected with urban growth and the consequent influence on water quality, biodiversity and air quality. As the State of Environment Report states, â€Å"in 2002/03, a total of 2,728 development applications were received in the Shire. Of these, 2,400 development applications were approved (54 less than approved in 2001/02). Of all development applications received, 13% were associated with new residential development. Medium density development accounted for 2% (50) of all development applications in 2002/03. † (State of Environment Report, p. 10). Sutherland Shire Council has been very efficient during the recent years in setting objectives and implementing all the activities regarding environmental protection. The plans issued by the Sutherland Council manage to cover all the necessary issues which rise in the shire during the recent years. On one hand, the council focuses on the modern developments made in the shire but it also devotes lots of attention to environmental problems. In order to achieve maximum efficiency, the council regards all the activities provided in the shire to improve the life of dwellers through the prism of environmental protection. This approach has proved to be very efficient for present day realities. As the Management Plan of Sutherland Shire states, â€Å"†¦Sustainability is the ability to provide choices for future generations of the Shire without compromising those of our generation. The Shire has made progress in addressing challenges in community issues and safety, the natural environment, and transport, identified in 2000. Further integration of transport choices with land use, which affects community issues, safety and the environment, is required. An informed democratic process which carefully addresses Shire risks, and continued commitment to sustainability in council management, are fundamental to achieving sustainability. † (Management Plan, 15) The perception of sustainability provided by Sutherland Shire Council plays a very important role in all the activities provided by the council. They include solving problems regarding community safety, transport, natural environment, and some other issues. The Management Plan and State of Environment Plan of Sutherland Shire both focus on ecologically sustainable development. The whole purpose of such development is taking into consideration all of the objectives which were set in NSW Local Government Act in 1993. The Management Plan has also been created according to the council adopted Our Guide for Shaping the Shire to 2030. The major strategic goals which the council states in the Management Plan are â€Å"†¦to pursue sustainability across economic, social and environmental considerations. We address economic, social and environmental issues on a day to day basis and in this plan, have made this more tangible with triple bottom line statements against our principal activities† (Management Plan, p. 12). The plan also states that the council’s vision of the shire is â€Å"a community working together to attain safe, healthy and active lifestyles, through accountable decision-making, that achieves sustainable development and economic opportunities, that respect people and nature† (Management Plan, p. 11). Describing the vision of the shire is a very important part of strategic planning of the council because the achievement of the marked vision of the shire is the major strategic goal which the council sets for the community. The strategic goal is expressed very well in the plan, and this enables the council to plan the activities carefully in order to achieve the goal. According to all of the mentioned documents, all the developments which take place in the shire during the following years had to be done without damaging the natural environment and preventing future generations from enjoying the benefits of clean water, beautiful gardens and many other advantages which nature has given to the shire long ago. The NSW Local Government Act stated that urban development which is currently occurring in the shire is very dangerous for the natural resources, for example water, air quality, biodiversity. Therefore, when adopting future plans for the development of shire, it was very important for the local council to take into consideration all the measures which would prevent natural environment from damage. Most of the measures taken during the recent years were very successful in this regard. According to the Sutherland Shire Management Plan, the two key components of ESD in local government are: a requirement for natural resource protection actions (e. g. bushland, waterways, tree canopy, etc. ) in all unit work programs, based on management plan development, including descriptions of individual management responsibilities within core business; reporting State of the Environment results including likely outcomes for key natural resource health indicators as a result of community decisions on planning options. (Management Plan, p. 14). The council has planned many measures which would be crucial in environmental protection. In the UN-Derived Local Action 21 Program, all the measures taken for integration of council with the community were marked. All of the joint efforts of the council and the community had to be devoted to eliminating environmental problems. For example, some measures were taken regarding the areas which are currently experiencing planning change. The main emphasize in the plan was made on the risk assessment techniques which would provide all of the necessary data about the possible damage which could be given to the environment in the result of the measures. All of the objectives set in the UN-Derived Local Action 21 Program answered the main strategic goals placed in front of the environment. The results of the program implementation however showed the lack of organization communication and some mistakes made during transport planning, therefore some more consideration had to be devoted to the structure of the program in order to eliminate negative impact of the mentioned factors. The main directions which the Council has set are very meaningful and help to implement all the activities which it has stated in the strategic goal: ? pursuing ecologically sustainable development, meeting the needs of the present generation without compromising those of the future; ? demonstrating organizational delivery of integrated services and be environmentally, socially and economically responsible and accountable; ? managing resources to maintain financial viability and enhance service provision? promoting access, equity and a sense of community (Management Plan, p. 11). Most of the directions which have been set by the Council are very complex and require joint efforts of people involved in the community life. In order to increase the efficiency of implementing the goals which have been set by the council, it makes a decision to encourage as many people as possible to participate in the community life. Therefore, increasing the number of citizens involved in the community life serves one of the ways to achieve the directions mentioned above. There are some other issues on which the council chooses to focus in order to meet all of the challenges which can arise from the objectives set by it. According to the Management Plan of Sutherland Shire, the main issues on which the council is planning to focus during the next years included the following: ? Nurture our clean and beautiful natural environment; ? Improve our suburbs; ? Increase the number of citizens involved in community life; ? Maintain our prosperous local economy; ? Build safe, healthy and active lifestyles; ? Business activities; ? Support services (Management Plan). As it’s possible to tell from the list of activities which the council was providing, the main feature of the plan was combining activities leading to the increase of the level of life of people in the shire, brining development into their lifestyles, and at the same time focusing on the measures of environmental protection. It’s very important that the council has devoted lots of attention to the issue of nurturing the clean and beautiful natural environment of the Sutherland Shire. This features of the plan shows that the major strategic goals which have been put in from of the council are being implemented. The importance of other measures which have been taken by the council, like increasing the number of citizens involved in the community life, increasing the prosperity of local economy, building active lifestyles are very important as well. Those are also one of the measures which have to be taken to prepare future generations for a happy and prosperous life. If actions taken to protect environment are very important for the future generations ecology vice because they guarantee them life in a clean environment, actions taken to increase the prosperity of the shire are equally important. One of the major features of the Management Plan and State of Environment Report of Sutherland Shire is that the mentioned actions don’t come into controversion with one another. This is a very important achievement of the council’s planning which can be marked as an outstanding one. As long as the objectives of environmental activities and of urban development activities are well-balanced, the results of the plan implementation will always be positive. There are many activities which have been planned by the Council in order to protect the environment. In the plan, there have been included many activities which dealt with people’s recreation (like building public golf courses, tennis courts, vacation facilities), providing services for youth and older people and some others, but the main attention was devoted to environmental issues. The list of activities planned by the Council to protect the environment includes the following responsibilities and services: ? animal shelter ? beaches ? Bushcare ? certification (for development) ? Cleansing of public places ? clean-up campaign ? Earthworks ? economic development support? environmental assessment and application determination ? environmental compliance ? environmental education ? environmental health and regulation ? environmental planning ? environmental research and policy ? parks maintenance and construction ? plan of management for community land ? roads construction and traffic management ? stormwater drainage ? street cleaning ? waste collection and education (Management Plan, p. 13). In order to have a full view of how the activities have been balanced in the Management Plan, it’s necessary to investigate the data which is provided in the organizational budget summary. According to the data of capital works budget, the Council spends the most financial resources on building safe, healthy and active lifestyles (19,537,713), non-divisional programs and indirect income (18,073,881), and improving suburbs (10,253,947). The financial resources which are spent on nurturing clean and beautiful nature environment are the next in the list by the volume of budget expenses and can be estimated by 6,561,895. This figure appears quite low in comparison with other activities on which budget money goes. In order to maintain the environment, it’s necessary for the Council to re-structure the expenses of the budget and make sure that more resources are channeled to the environmental protection. The amount of budget money spent on building safe, healthy and active lifestyles is too high, and it’s important for the Council to devote enough attention to environmental protection. The resources which have been channeled for this issue are insufficient, and it’s necessary for the budget planners to take a closer look at this problem. The environmental programs which have been planned by the Council require substantial financial support, therefore the budget has to be planned accordingly to the possible cost of the programs. For example, as the State of Environment report marks, the following programs have been initiated by the Council: Oyster Bay Trip Substitution Project, Beaches to Bay Bus, Travel access Guides in order to reduce car use. Those projects need substantial financial support from the government. It’s very important to take measures in protecting environmentally sensitive land such as Botany Bay National Park, Geroges River National Park, Heathcote National Park, Royal National Park. In order to protect environmentally sensitive land, financial support from the council is very much needed, and large sums of money have to be channeled to the mentioned activities. As the investigations have shown, the Southerland Shire Management Plan and State of Environment report provide sufficient strategic and operational directions. They both reflect all of the strategic goals which have been set for the shire in order to provide choices for future generations without preventing present generations from enjoying all the benefits of nowadays reality. The actions marked in the plan represent a compromise between the necessity of rapid urban growth dictated by present day realities and the necessity to protect environment for future generations to enjoy beautiful nature and clean air in the same way we do now. Bibliography. 1. Management Plan. Sutherland Shire Council. 2. NSW Local Government Act, 1993. 3. State of Environment Report 2002/2003. Sutherland Shire Council.

Infamous Salem Witch Trials - Free Essay Example

Sample details Pages: 4 Words: 1095 Downloads: 2 Date added: 2019/05/21 Category History Essay Level High school Tags: Salem Witch Trials Essay Did you like this example? When looking back at American history, there are many historic events that have either helped shape or change Americars future. However, one of the most memorable years has to be the year of 1692, for this was one of the most scandalous times that is famously remembered in history. This is best known as the infamous Salem Witch Trials. The Salem witch trials was a disastrous event in which certain people were either falsely or rightfully accused of practicing witchcraft and sentenced to be either hanged or sent to jail. Even though these trials took place in a number of cities within the Massachusetts Bay Colony, it was being primarily focused in the town of Salem between February 1692 and May 1693. These trials were by far the largest witchcraft hysteria in the history of Colonial America. Don’t waste time! Our writers will create an original "Infamous Salem Witch Trials" essay for you Create order The start of these trials began during the spring of 1692; a group of young girls in Salem began claiming that they have been possessed by the devil. All through the summer of 1692 the convictions mounted. The first hanging, of Bridget Bishop, took place on June 10, the next five, including Rebecca Nurse, on July 19. On August 19 five more, four of them men, were hanged (Brandt, 2014, p. 34â€Å"43). During these accusations, Mather began to defend the trials by ignoring the form of evidence based upon dreams and visions. This type of evidence is called Spectral evidence, Mather used this to convict those he believed were witches and began to become a main key in the trials of four of the five accused, unlike Bridget Bishoprs trial. The New Englanders are a people of god settled in those, which were once the Devilrs territories (Mather, 2017, p. 12). Shortly after, the court apparently overlooked Mathers warning about ignoring spectral evidence but took to heart his exhortation to c leanse the land, and the pace of the trials picked up (Hoffer, 1997). People felt the use of spectral evidence was unreliable because the Devil could take the form of an innocent person to do his evil deeds. With the girls displaying strange behaviors and showing symptoms of illness, more people in Salem began displaying the same signs of distress. Everyone became a suspect of witchcraft, and it was only a matter of time before someone accused them to be tried in court. Although most of the accused witches were women, some men were also accused. The Puritans began to fear whether or not they were to be punished and/or hanged. In his book The Salem Witchcraft Trials, author Peter Charles Hoffer describes this human fear as part of the frailty of human nature. Whether it was the fear of disobeying God or hysteria that motivated these trials to take place, the accusations did not stop anytime soon. As time went on and the number of accused continued to grow, several people became upset with the trials. Many risked their own safety by starting petitions on behalf of the imprisoned (Loiselle, 2017, p. 5). During this time period, religion was the primary focus and way of life within small colonies. In this case, those in Salem mainly followed the Puritan way of life. Puritans began to define witchcraft as associating with the devil in exchange for certain powers in order to perform such cruel acts against others. During this time, witchcraft was considered both a sin and crime because it denied Godrs own superiority and brought physical harm to others. The Puritans began to feel that these events were happening because God was punishing them for the hangings of innocent people. The fear of being punished established a tense atmosphere and enforced the idea that anything involved with witchcraft was interpreted as an act of Gods wrath. Using their own belief and fear, they wanted to make sure that every last witch were to be exposed and punished in order to end the wrath of God. By the end of May 1692, around 200 people were jailed and charged with witchcraft. Shortly after accusing hundreds of people, some Puritans actually started to wonder whether or not the girls were being truthful or just trying to be spiteful towards their enemies. It also ended when people noticed that fewer people were confessing and more people were hanging. The Salem witch hunt and trials finally ended when people began to notice that people were being accused of witchcraft even when they had no evidence. The aftermath of the Salem witch trials was severe:141 people imprisoned, 19 people executed, and two more died from other causes. After months of doing these trials, the governor finally decided to put an end to the trials in May of 1693. The trials were declared unlawful and Massachusetts formally apologized for the trials. More than 200 people were accused, nineteen of whom were found guilty and executed by hanging. It was a tragic event that took place. This time period was unique for New England because of the number of terrible things that were occurring around the same time of these trials. Historically, there had never been a witch hunt of that intensity or size in America. After the trials took place, ideas about justice started to change after the trial. Spectral evidence was no longer accepted in court and the American idea that someone is innocent until proven guilty appeared. Salem faced a major change as a result of the Puritan ambition. Because of their thought on the ideal community as a straitlaced society, those who portrayed an imperfect model were to be isolated. It has been used in political rhetoric and popular literature as a vivid cautionary tale about the dangers of isolationism, religious extremism, false accusations, and lapses in due processes. The painful legacy of the Salem witch trials would endure for centuries. Hundreds of people were accused of being witches and the pastors of the local churches began to have their own trials in order to determine who was and who wasnt a witch. Salem executed the most people for being witches. Although the Salem trials were not the last, because of the Massachusetts authorities actions in discovering, acknowledging, and disowning their errors, the Salem experience helped to end witchcraft trials in Western civilization (Billings Manning, 2006). The question of what specifically caused these trials has been asked for over several decades. Although it is a simple question, the answer is difficult to answer because there are numerous factors that helped build and influence the trials. The main factors consisted of politics, religion, enemies, family feuds, and the fear of witchcraft. We may never know the cause of the Salem Witch Trials, but that will not stop scholars from evolving theories.