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To understand mental disorders, one must know something of how the brain functions, comprehend the basics of human psychology and how life s circumstances affect behavior, and at the same time, the effective physician must always be sensitive to the psychological needs of his patients and express a sincere desire to help them The rst two of these objectives require special study; the latter ones are more innate qualities, found in all good physicians Indeed, the societal recognition awarded our profession is the result of sympathy for the sick and the willingness to put the patient s welfare ahead of our own attributes that meet their greatest challenge in dealing with the mentally ill Mental disorders pose a number of special problems not met in other elds of medicine First, there are such wide variations in personality, character, and behavior that the point where normal ends and abnormal begins is sometimes dif cult to determine Second, most of the methods of studying mental illness are quite subjective, derived mainly from the physician s perceptions of the inner thoughts and purposes of the patient and from the patient s powers of narration in revealing his symptoms The patients capacities to provide this information vary with intelligence, personality, education, and cerebral function Only with some knowledge of the patient s natural endowment, education, premorbid personality, cultural background, and stability of emotional control, can such differences be understood Third, and most unusual for the neurologist, it is easily appreciated that the classic mental diseases are not due to obvious lesions in one part of the brain, or even in one ensemble of physiologically or neurochemically related systems of the brain Finally, the clinical entities of mental disease presented in the following chapters are not easily veri able by laboratory tests or postmortem examination In attempting to study psychiatric disorders, one must be aware of another, more abstruse and essentially theoretical problem Here, physicians nd that there are two different and seemingly antithetical approaches to disordered nervous function one proceeding along strictly medical or neurologic lines, the other, psychologically based These two types of data, one drawn from observations of the patient s behavior, the other from the patient s introspections are acknowledged and incorporated It must be emphasized that the terms neurologic and psychologic in this context do not necessarily refer to the activities of neurologists and psychiatrists They are merely convenient terms for two distinct approaches to mental disorders This brings us face to face with a theoretical problem that is posed by more complex psychiatric diseases of the brain The neurologic approach begins with the premise that all clinical manifestations of a nervous disorder are expressions of a pathologic process (disease) within the nervous system This process may be obvious (such as a tumor or cerebral infarct), or it may be impossible to detect with the light and electron microscope (such as delirium tremens) Admittedly, brain processes such as perceiving, thinking, remembering, symbolization, are deranged but not readily reduceable to a coherent biological system The mode of approach to disordered mental function and behavior, which one may term the psychologic, or psychodynamic, has as its main premise that the disordered function has its roots in and is understandable largely in terms of previous or present life experiences Certain abnormalities of behavior, emotional immaturity, and inability to adjust to the challenges and opportunities of everyday life are thought to stem from an inadequate development of personality, distressing experiences in early life, or both Some of these experiences are remembered (ie, conscious ); others are said to be suppressed or forgotten (ie, subconscious or unconscious, according to psychoanalytic theory) and recalled only with dif culty or by questioning or through the free-association method of psychoanalysis The principal method is to construct a kind of psychologic autobiography of the individual, with particular emphasis on early life experiences, and to search it for the roots of the present psychologic dif culty Psychiatrists of this persuasion have formulated a number of psychologic mechanisms whereby symptoms are produced, and they speak of them in a language rather unfamiliar to most physicians eg, con ict, repression, conversion, projection, displacement of affect, conditioning, and arrest or xation of libido The purpose of this approach is not only to determine causality but also to understand the patient s current behavior in the light of past experiences and to use this under-.

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he continuous availability of business-critical information is a key requirement for enterprises to survive in today s information-based economy Enterprise database systems managing critical data such as financial and customer information, and operational data such as orders, need to be available at all times Making important business decisions based on these systems requires the databases storing this data to provide high-service uptime with enhanced reliability When the loss of data or the database service occurs due to planned events such as software patching and upgrading, or due to unforeseen events such as media failures, data corruption, or disasters, the data and the database service need to be recovered quickly and accurately If recovery cannot be performed in the optimal timeframe as dictated by the business Service Level Agreements (SLA), the business can incur loss of revenues and customers Choosing the right high-availability architecture of the Exadata Database Machine will enable the enterprises to safeguard critical data and provide the highest level of service, availability, and reliability The basic premise of high-availability architectures is based on redundancies across the hardware and software components in the deployment architecture Redundant systems provide high availability when remaining active at the same time High availability can also be built into the software layer by incorporating features that provide continuous availability of data A few examples are the features that help repair data corruption, perform online maintenance operations, and help you recover from user errors while the database remains available Oracle provides a myriad of high-availability technologies for implementing highly available database systems This chapter highlights such technologies and the recommended practices and guidelines for implementing them We will also discuss the best-practice methods of performing backup and recovery on the Oracle Exadata Database Machine

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