The Prevalence Of Hearing Loss - 3583 Words

Hearing loss is prevalent, treatable and frequently undetected (Uhlmann, 1989). It is widely accepted that the prevalence of hearing impairment increases with age. This age related hearing loss is known as presbycusis. Acar, Yurekli, Babademez, Karabulut and Karasen (2011) described presbycusis as a social problem in which people deliberately restrict physical and social activities. There is a prediction for an increasing prevalence of hearing loss due to the greater aging population, the use of personal listening devices, and increased military action. Aging Auditory System and Speech Understanding Aging is the single factor that is most responsible for irreversible hearing loss due to weakening of the tympanic membrane, disordered†¦show more content†¦Yet, the understanding of distorted speech declines rapidly and dramatically with aging and hearing ability (Divenyi et al., 2005). Even with a favorable speech-to-noise ratio, like in a sound treated suite, a mild high frequency hearing loss can affect speech understanding (Lunner, Rudner, Rà ¶nnberg, 2009). Reverberation and signal processing in noise are the greatest obstacles to understanding speech (Gordon-Salant, 2005). Reverberation has a smoothing effect on the sound waveform which causes distortion of the signal (Gordon-Salant, 2005). This phenomenon occurs in large, open rooms which is why many adults complain about understanding speech in noisy restaurants. Elderly, hearing-impaired listeners indicate that they have the most difficulty understanding continuous input in the presence of noise as opposed to dif ficulty understanding just single words and phrases in the presence of noise (Pichora-Fuller, 2003).When the peripheral auditory system is already damaged from typical auditory aging processes, adding more distortion to the signal decreases the listener’s ability to understand. These deficits indicate a slowing of perceptual processes. The question remains, how quickly do these components decline, at what rate and to what degree does speech understanding diminish (Divenyi et al., 2005)? Audiological Evaluation In order to determine theShow MoreRelatedSocio Demographic Profile And Nutritional Status Of Hearing Impaired1594 Words   |  7 PagesSCIENCE Title : SOCIO-DEMOGRAPHIC PROFILE AND NUTRITIONAL STATUS OF HEARING IMPAIRED (DEAF) ADOLESCENTS Abstract Health status of a population is a significant indicator of human development. Like mortality, disability being a potential measure of health status of population has not received much attention in research particularly in the developing countries. Hearing impairment refers to both complete and partial loss of the ability to hear and research in the area of the health andRead MoreObstructive Sleep Apnea ( Osa )1602 Words   |  7 Pagesproblem affecting millions of people in the United States. The prevalence of OSA has risen drastically over the past few decades concurrently with the increasing prevalence of obesity. Subsequently, there has been an ever-increasing rise in the use of CPAP. While there are many adverse effects to the use of CPAP, the majority are described as being relatively benign. Here we discuss a case of significant sudden sensorineural hearing loss (SSNHL) in relation to a suspected perilymphatic from traumaticRead MoreGenetics Synthesis: Marfan Synd rome Essay1514 Words   |  7 Pagesat the nape of the neck, single transverse palmar crease, and short fifth finger with clinodactyly and wide spacing, often with a deep plantar groove between the first and second toes. Cognitive impairment is mild to severe, significant risk of hearing loss, obstructive sleep apnea, otitis media, eye disease (including cataracts and severe refractive errors), congenital heart defects, neurological dysfunction, gastrointestinal atresias, hip dislocation, thyroid disease, and less common transient myeloproliferativeRead MoreDiabetes And Hearing Loss Among Americans Essay1495 Words   |  6 PagesDiabetes Has on Hearing Diabetes is regarded one of the major health concerns in the United States given the increase of diabetes cases throughout the country. In the past few decades, diabetes has continued to affect adults and children in the United States. The increase of this condition has been associated with several considerable impacts since it generates numerous medical and related phenomena in the American society. One of the medical phenomena generated by diabetes is hearing loss given thatRead MoreA Study By Brigham And Women s Hospital1546 Words   |  7 Pagesand Women’s Hospital in Boston found that one in five teens suffer from a hearing impairment, which is an increase of 33% from 1994 (Dignan). Earbuds and headphones have contributed to these numbers since using these at loud volumes can damage ears over time. Earbuds and headphones have caused loss of hearing, as a result, there should be a restriction on the highest volume they can go. To put this into perspective, hearing is an important function of the body, taking many components to transferRead MoreThe Purpose For This Research Proposal Is To Introduce1209 Words   |  5 Pagesaware of. Findings done by previous studies have provided numerous birth effects caused by the Zika virus. Such as congenital deficiencies: Microcephaly, sensory outcomes, motor and limb abilities, and neurological abnormalities. However, the prevalence and incidence rate of transmission from mother to fetus by trimester hasn’t been identified. Introduction: It’s been 70 years since the introduction of the Zika Virus in Uganda, and so far, researchers have identified the vector: aedes mosquitoRead MoreHearing Loss And Its Effect On The Audience s Ability867 Words   |  4 PagesHearing loss can impact the listener’s ability to spatially separate the target signal and the masker. Researchers have indicated that the benefit obtained from spatial release from masking is less for individuals with hearing loss from individuals with normal hearing (Gallun et al., 2013; Abrogast et al., 2005). Interaural level and time differences underlie the benefit of spatial separation of target speech and sources of masking. Hearing loss results in a reduced ability to use these ITDs andRead MoreDemographic Structure Includes Name, Age, Sex And Ethnicity1071 Words   |  5 Pagesin the same individual but in varying degrees. Others may have autistic spectrum disorder with hearing loss. The presence of an undiagnosed hearing loss is likely t o make the learning disabilities or difficulties appear worse than they actually are.In addition, undiagnosed hearing loss may lead to challenging behaviours and other types of psychological distress that could be decreased if the hearing loss is diagnosed and treated. Denmark (1994) highlighted that deaf people within the general populationRead MorePsychopathology And Permanent Hearing Loss1403 Words   |  6 PagesPsychopathology and Permanent Hearing Loss in Pediatric Patient Population Laura Shipps Dr. Andrea Pittman SHS 508 – Pediatric Audiology 04/29/15 Pediatric Audiology and Psychopathology Permanent hearing loss at any age can be challenging; adults and children alike must adjust to the reduced ability to hear. Unlike adults, however, children are still learning the language and communication skills that they will use for the rest of their life. As such, hearing loss that occurs duringRead MoreSocio Demographic Profile And Nutritional Status Of Hearing Impaired2148 Words   |  9 Pages SOCIO-DEMOGRAPHIC PROFILE AND NUTRITIONAL STATUS OF HEARING IMPAIRED (DEAF) ADOLESCENTS Abstract Background: Health status of a population is a significant indicator of human development. Like mortality, disability being a potential measure of health status of population has not received much attention in research particularly in the developing countries. Hearing impairment refers to both complete and partial loss of the ability to hear and research in the area of the health and nutritional

Irony, Allusion, Metaphor, Personification, Alliteration,...

Describe the setting of this novel. The boys are stranded on an unoccupied island. It seems as though it is somewhere in the Pacific in the 1950’s. It is an unknown environment which is very peculiar. As young boys, they expressed a great amount of enthusiasm once they arrived. After this initial feeling, the reality of the absence of adult supervision came to their realization, and the threat of the real world set in. This island possesses several jungle characteristics such as dense undergrowth. There is plenty of food and wild fruit. This is a deserted tropical island. Explain Golding’s use of the following literary devices using evidence from the novel: irony, allusion, simile, symbol, slang, repetition, personification, alliteration,†¦show more content†¦Personification: As mentioned on page 19, â€Å"Sleep enveloped him like swathing mirages that were wrestling with the brilliance of the lagoon.† Alliteration: The ululation rose behind him and spread along, a series of short sharp cries, the sighting call. The usage of the ‘s’ sound is used to deliver a abrupt and sneaky sound. Comic Relief: â€Å"He tried to convey the compulsion to track down and kill that was swallowing him up.† Jack is slowly transforming from civilized to savage. What is the dramatic situation at the beginning of the novel? Ralph is a twelve year old boy with fair hair who climbs out of a plane wreckage on an island towards a lagoon. He comes in contact with a boy who seems to be around the same age as him. They differ in appearance as this boy is fat and wears glasses. Ralph goes ahead and introduces himself. The fat boy doesn’t reveal his name, instead he tells a story about how his classmates at school gave him the nickname ‘Piggy.’ He reveals that he would prefer not to be called ‘Piggy’, but reluctantly, Ralph assigns that as his name. They discuss how both boys survived a plane crash in the Pacific Ocean and how there is an obvious absences of adult authority on this island. It appears as though both boys escaped from a war in their home countries. What causes the boy s’ terror? The belief that there is a beast on the island is what causes the boy s’ terror. Nobody sees it except them ,but the boys areShow MoreRelatedHello2980 Words   |  12 Pagesthese characters, things, events is meant to reveal an abstraction or a truth. These characters, etc. may be symbolic of the ideas referred to. Alliteration—The repetition at close intervals of initial identical consonant sounds. Allusion—An indirect reference to something (usually a literary text) with which the reader is expected to be familiar. Allusions are usually literary, historical, Biblical, or mythological. Ambiguity—An event or situation that may be interpreted in more than one way. AlsoRead MoreAmerican Literature11652 Words   |  47 Pagesof American Literature - 1900-1946 Content: ï‚ · ï‚ · ï‚ · dominant mood: alienation and disconnection people unable to communicate effectively fear of eroding traditions and grief over loss of the past Genre/Style: ï‚ · ï‚ · ï‚ · ï‚ · highly experimental allusions in writing often refer to classical Greek and Roman writings use of fragments, juxtaposition, interior monologue, and stream of consciousness writers seeking to create a unique style Effect: ï‚ · common readers are alienated by this literature Read MoreANALIZ TEXT INTERPRETATION AND ANALYSIS28843 Words   |  116 PagesCrane, the gangling schoolmaster in Irving’s The Legend of Sleepy Hollow, resembles his long-legged namesake. Names can also contain literary or historical allusions that aid in characterization by means of association. The name ‘Ethan Brand’, referring to the wandering lime burner who gives his name to Hawthorne’s short story, contains an allusion to the mark or brand of Cain a legacy of guilt that the outcast Brand shares with his Biblical counterpart. One must also, however, be alert to names used

Affirmative actions Essay Example For Students

Affirmative actions Essay Throughout Boston, conflicting issues have ragged causeing great toils in the school systems. Recently, during the nineties places of employment along with schoolsAffirmative Actionshave been hammered by the Affirmative action laws. These laws, stating their must be a set number of minorities (depending on population) to help minorities gain retribution from their past. In one instance the McLaughlins, a white family, filed a suite against the best school in the city, Boston Latin. Twelve year old Julia wanted to attend this school. She scored well enough on her entracnce exam yet she was still denied due to the quota system. Although this case went through a full hearing, Judge Garrity rulled to keep the quota system which in turn denied Julia from the school. Ever since the first blacks wer introduced, white people have discriminated greatly. Now, with modern times and law our societies have produced policies of Affirmative actions to level the playing field. Although their may not be as much discrimination now as in the early 1900,s we still have the obligation to provide retribution to these minorities. Affirmative actions allows blacks to be judged by thier characters and qualifications rather than by their skin color. Along the same lines, for some reason the majorities in this country still feel they are some what saperior to our minorities. With the Affirmative action policies in place it helps employers and schools look closer at these minorities. Quotas are set throughout the country to provide minorities with equal opportunities in thse places. Although this seems to give minorities a break, all it really is doing is equalling everybody to provide opportunities to the minorities. This seems to balance out the runnings by providing minorities with educations and jobs they normally would not attain due to discrimination. Finally, Affirmative actions are great for the modern generations. Schools and job sites are becoming more and more diverse. The younger generations growing to be our next presidents or nuclear fissisists, will now hopefully beging to learn and work intergrated with these minorities. Hopefully sometime in the near future discrimination will come to an end and all people will be able to live intertwined with different cultures and religions. Although Affirmative actions seems to help minorities it really harms them. Programs that are based on a racial preference instead of their performance tends to create a victim mentality. If we go on letting the minorities believe this we will never move on. Minorities will go on thinking were not good enough to earn this position, so they have to be given to us. Ultimately, this will lead to minorities always getting a break which in turn makes them feel inferior to those who have to work for their placements. Many things are said in support of Affirmative actions including ; It promotes diversity, It makes up for their past, or even that it promotes equal opportunity for minorities. Now, these things might be true on a certain level. We have to look at which groups of minorities are they actually helping. Yes they are helping the blacks or the Aisians, but are they helping important groups like the poor. Widespread throughout the nation we have the group of people that were born into a poor environment. These people will never have enough money to go to a college or a technical school so almost always they never make an economical or social advancement. Now you would thing that the affirmative action laws would do something about this trying to help them move up, but you do not see this happening. Considering the poor as a minority, and how they are not helped, wouldnt this decscribe the Affirmative action laws as being discriminant. If so, what good do they actually do?Affirmative action forces empoyers and admissions of schools to use quota systems in gaining their empoyees or students, even though quotas were banned early in the century by a civil rights act. These quotas are persuasive and public opinion polls show almost eighty percent of the population oppose them. Although they try to promote diversity with these techniques, it ultimatly increases the hatred between these groups. (ex. whites and blacks)By using these quotas can we actually say were helping? We give minorities breaks, which leads to somebody getting screwed out of something due to skin color. Is this fair or is it purly another act of discrimnation?With all the information and examples I have provided here, I feel the Boston, Latin case was very simple to decide. Amongst the information, included several reasons the Affirative actions policy does nothing but harms the progress our country has made since the beginging of discrimination. When Judge Garrity made the decision to keep the quota sys tem he made a choice to continue discrimination. Ultimatly the tables have turned, and now our faithful government has made it legal to discriminate agains the majorities. Is it right? Maybe not, but their is nothing that can be done about it, unless Garrity would have made the oposite decision that he did. It is too late now, but we who are against the policies can still voice our opinions. .ubf27c507c3d31cdab1351f66cefb0b13 , .ubf27c507c3d31cdab1351f66cefb0b13 .postImageUrl , .ubf27c507c3d31cdab1351f66cefb0b13 .centered-text-area { min-height: 80px; position: relative; } .ubf27c507c3d31cdab1351f66cefb0b13 , .ubf27c507c3d31cdab1351f66cefb0b13:hover , .ubf27c507c3d31cdab1351f66cefb0b13:visited , .ubf27c507c3d31cdab1351f66cefb0b13:active { border:0!important; } .ubf27c507c3d31cdab1351f66cefb0b13 .clearfix:after { content: ""; display: table; clear: both; } .ubf27c507c3d31cdab1351f66cefb0b13 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .ubf27c507c3d31cdab1351f66cefb0b13:active , .ubf27c507c3d31cdab1351f66cefb0b13:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .ubf27c507c3d31cdab1351f66cefb0b13 .centered-text-area { width: 100%; position: relative ; } .ubf27c507c3d31cdab1351f66cefb0b13 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .ubf27c507c3d31cdab1351f66cefb0b13 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .ubf27c507c3d31cdab1351f66cefb0b13 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .ubf27c507c3d31cdab1351f66cefb0b13:hover .ctaButton { background-color: #34495E!important; } .ubf27c507c3d31cdab1351f66cefb0b13 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .ubf27c507c3d31cdab1351f66cefb0b13 .ubf27c507c3d31cdab1351f66cefb0b13-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .ubf27c507c3d31cdab1351f66cefb0b13:after { content: ""; display: block; clear: both; } READ: Trifles by Susan Glaspell EssayBibliography:

Shimla the Hill Queen free essay sample

After independence, city became the capital of Punjab and was later named the capital of Himachal Pradesh. Shimla came into existence from 1st Sept,1972 on the reorganisation of the districts of the state. After the reorganisation, the erstwhile Mahasu district and its major portion was merged with Shimla. Its name has been derived from the goddess Shyamala Devi, an incarnation of the Hindu goddess Kali. As of 2011 Shimla comprises 19 erstwhile hill states mainly Balson, Bushahr, Bhaji and Koti, Darkoti, Tharoch Dhadi, Kumharsain, Khaneti Delath, Dhami, Jubbal, Keothal, Madhan, Rawingarh, Ratesh, and Sangri. As a large and growing city, Shimla is home to many well-recognized colleges and research institutions in India. The city has a large number of temples and palaces. Shimla is also well noted for its buildings styled in Tudorbethan and neo-Gothic architecture dating from the colonial era. History The bridge connecting Shimla with Minor Shimla, erected in 1829 by Lord Combermere, Shimla, 1850s Shimla, along with Almora, Kumaon, Garhwal, Sirmaur, Dehradun and Kangra, was invaded and captured by Prithvi Narayan Shah of Nepal. Shortly later, the British East India Company with local kings went to war with Nepal from 1814 to 1816. At the conclusion of the war, as a result of the Sugauli Treaty, all these captured parts of North India were ceded to the British East India company. At that time, Shimla was known for the temple of Hindu Goddess Shyamala Devi, and not as a city as it is today. Not long after gaining possession of Shimla, the British began to develop the area. The Scottish civil servant Charles Pratt Kennedy built the first British summer home in the town in 1822. Lord Amherst, the Governor-General of Bengal from 1823 to 1828, set up a summer camp here in 1827, when there was only one cottage in the town, and only half a dozen when he left that year. There were more than a hundred cottages within ten years. Shimla soon caught the eye of Lord William Bentinck, the next Governor-General of Bengal from 1828 (later of India, when the title was created in 1833) to 1835. In a letter to Colonel Churchill in 1832, he wrote â€Å" Simla is only four days march from Loodianah (Ludhiana), is easy of access, and proves a very agreeable refuge from the burning plains of Hindoostaun (Hindustan). Rashtrapati Niwas, Observatory Hill, Shimla, the former Viceregal Lodge, completed in 1888 now the Indian Institute of Advanced Study One of his successors, Sir John Lawrence (Viceroy of India 1864–1869), decided to take the trouble of moving the administration twice a year between Calcutta and this separate centre over 1,000 miles away, despite the fact tha t it was difficult to reach. Lord Lytton (Viceroy of India 1876–1880) made efforts to plan the town from 1876, when he first stayed in a rented house, but began plans for a Viceregal Lodge, later built on Observatory Hill. A fire cleared much of the area where the native Indian population lived (the Upper Bazaar), and the planning of the eastern end to become the centre of the European town forced these to live in the Middle and Lower Bazaars on the lower terraces descending the steep slopes from the Ridge. The Upper Bazaar was cleared for a Town Hall, with many facilities such as library and theatre, as well as offices—for police and military volunteers as well as municipal administration. During the Hot Weather, Simla was also the Headquarters of the Commander-in-Chief, India, the head of the Indian Army, and many Departments of the Government. The summer capital of the regional Government of the Punjab moved from Murree, in modern-day Pakistan, to Shimla in 1876. They were joined by many of the British wives and daughters of the men who remained on the plains. Together these formed Simla Society, which, according to Charles Allen,[4] was as close as British India ever came to having an upper crust. This may have been helped by the fact that it was very expensive, having an ideal climate and thus being desirable, as well as having limited accommodation. British soldiers, merchants, and civil servants moved here each year to escape from the heat during summer in the Indo-Gangetic plain. The presence of many bachelors and unattached men, as well as the many women passing the hot weather there, gave Simla a reputation for adultery, and at least gossip about adultery: as Rudyard Kipling said in a letter cited by Allen, it had a reputation for frivolity, gossip and intrigue. See also. [5]) Passenger train on the Kalka-Shimla Railway route The Kalka-Shimla railway line, constructed in 1906, added to Shimlas accessibility and popularity. The railway route from Kalka to Shimla, with more than 806 bridges and 103 tunnels, was touted as an engineering feat and came to be known as the British Jewel of the Orient. [5] In 2008, it became part of the UNESCO World Heritage Site, Mountain railways of India. [6] Not only that, there was a significant Muslim population in the region before the partition of British India. In addition, Shimla was the capital of the undivided state of Punjab in 1871, and remained so until the construction of the new city of Chandigarh (the present-day capital of Punjab)[dubious – discuss] Upon the formation of the state of Himachal Pradesh in 1971, Shimla was named its capital. Pre-independence structures still dot Shimla; buildings such as the former Viceregal Lodge, Auckland House, Christ Church, Gorton Castle, Shimla Town Hall and The Gaiety Theatre are reminders of British rule in India. [7][8] The original Peterhoff, another Viceregal residence, burned down in 1981. British Simla extended about a mile and a half along the ridge between Jakhoo Hill and Prospect Hill. The central spine was The Mall, which ran along the length of the ridge, with a Mall Extension southwards, closed to all carriages except those of the Viceroy and his wife. Geography Skating at Simla, c. 1905 Shimla lies in the north-western ranges of the Himalayas. It is located at 31. 61 °N 77. 10 °E with an average altitude of 2397. 59 meters (7866. 10 ft) above mean sea level, the city is spread on a ridge and its seven spurs. The city stretches nearly 9. km from east to west. [9] The highest point in Shimla, at 2454 meters (8051 ft), is the Jakhoo hill. Shimla is a Zone IV (High Damage Risk Zone) per the Earthquake hazard zoning of India. Weak construction techniques and increasing population pose a serious threat to the already earthquake prone region. [10][11] There are no bodies of water near the main city and the closest river, Sutlej, is about 21 km (13 mi) away. [12] O ther rivers that flow through the Shimla district, although further from the city, are Giri, and Pabbar (both are tributaries of Yamuna). The green belt in Shimla planning area is spread over 414 hectares (1023 acres). [5] The main forests in and around the city are that of pine, deodar, oak and rhododendron. [13] Environmental degradation due to the increasing number of tourists every year without the infrastructure to support them has resulted in Shimla losing its popular appeal as an ecotourism spot. [14] Another rising concern in the region are the frequent number of landslides that often take place after heavy rains. [10][15] Climate Shimla features a subtropical highland climate under the Koppen climate classification. The climate in Shimla is predominantly cool during winters, and moderately warm during summer. Temperatures typically range from ? 4  °C (25  °F) to 31  °C (88  °F) over the course of a year. [16] The average temperature during summer is between 19  °C (66  °F) and 28  °C (82  °F), and between ? 1  °C (30  °F) and 10  °C (50  °F) in winter. Monthly precipitation varies between 15 millimetres (0. 59 in) in November to 434 millimetres (17. in) in August. It is typically around 45 millimetres (1. 8 in) per month during winter and spring and around 175 millimetres (6. 9 in) in June as the monsoon approaches. The average total annual precipitation is 1,575 millimetres (62 in), which is much less than most other hill stations but still greatly heavier than on the plains. Snowfall in the region, which historically has taken place in the month of December, has lately (over the last fifteen years) been happening in January or early February every year. [17] Economy

Approach to Care of Cancer free essay sample

Cancer is considered the second leading cause of death in the United States resulting in about 25% of deaths (Copstead, Banasik, 2010). The term cancer encompasses a cluster of more than one hundred diseases. Though there are various kinds of cancer, all cancers start due to abnormal cells growth. The typical characteristic of a cancerous cell is that they grow out of control and invade other tissue through the bloodstream or lymph vessels. If untreated, cancers can result in serious complications and death (American cancer Society (ACS), 2012). Although the cause of various cancers remains unknown, still there are several known causes such as: genetic factors; lifestyle factors such as smoking, alcohol use, diet, and physical activity; certain types of infections for example, HPV and HIV; and environmental exposures to different types of chemicals and radiation (ACS, 2014). It is predicted by ACS (2012) that 1/2 of all men and 1/3 of all women in the United States will develop cancer in their lifetime. We will write a custom essay sample on Approach to Care of Cancer or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The risk of many cancers could be minimized by lifestyle modification and screening. This paper will discuss the diagnosis and staging of cancer, three complications of the disease, side effects of treatment, and methods to minimize physical and psychological effects of cancer treatments. Diagnosis There is not a single test to confirm the diagnosis of cancer; it requires series of different test to confirm the diagnosis. It usually begins with obtaining detailed history and conducting physical examination. The patient symptoms differ depending on the type and extent of the disease. Localized symptoms of cancer relate to the primary site of the disease. The seven warning signs of cancer includes change in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge, thickening or lump in an area of the body, indigestion or difficulty in swallowing, obvious change in wart or mole, and nagging cough or hoarseness (Copstead, Banasik, 2010). Presence of any of these signs, along with detailed history, will not confirm the diagnosis but alert the practitioner to start a complete cancer work up. The work up will include imaging studies to identify location, size, and or metastasis. The imaging studies may include x-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and positron emission tomography (PET) scans (National Cancer Institute, 2014). Lab test may include studies of blood, urine and other bodily fluids. It may also include tests for various tumor markers, which may be elevated due to presence of cancer (National Cancer Institute, 2014). For example, elevated prostate-specific antigen (PSA) may indicate prostate cancer, and elevated alpha-fetoprotein (AFP) may indicate liver cancer (Stanford Medicine, 2014). All these tests may suggest presence of cancer but to establish a definitive diagnosis and properly classify the disease biopsy is essential. A cancer diagnosis is mostly confirmed by obtaining cell or tissue sample for pathology study through biopsy. There are various methods of tissue removal for examination. For example, fine needle biopsy (fine needle aspiration), core needle biopsy (core biopsy), excisional or incisional biopsy, endoscopic biopsy, and skin biopsies (ACS, 2013). Irrespective of the technique, the goal of the microscopic examination is to confirm the diagnosis of cancer. The pathologist could usually grade and indicate the type of cancer by microscopic examination with routine processing and staining but sometimes additional tests are required. For example, immunohistochemical (IHC) or immunoperoxidase stains, electron microscopy, flow cytometry, image cytometry, cytogenetics, and Polymerase chain reaction (PCR) (ACS, 2013). Staging Grading and staging in cancer is use to predict the prognosis of a malignant tumor and to plan treatment modalities. Grading denotes to the histologic classification of tumor cells and determines the degree of anaplasia. Normally grading systems classify tumors in 3-4 categories of increasing degrees of malignancy. Treatment is mostly determined by the staging of the tumor. Staging defines the site and spread of a tumor in an individual patient. Staging considers the tumor size, extent of local growth, lymph node and organ involvement, and presence of distant metastases. There are different staging systems in use; nonetheless, the international TNM staging system is most widely used system for cancer staging (Copstead, Banasik, 2010). â€Å"T† represents the main tumor, â€Å"N† indicates lymph node involvement, and â€Å"M† relates to metastasis. A numeric value is place next to each letter to specify the size and extent of the tumor and the degree of metastasis. For example, Tx means tumor is not measurable, T0 indicates no primary tumor found, Tis signifies carcinoma in situ (present but not spread), and T1-4 indicates the size and extent of the primary tumor. When referring to lymph nodes Nx means regional lymph nodes could not be evaluated, N0 denotes that no lymph node involvement present, and N1-3 indicates the degree of lymph node involvement. When staging metastasis Mx means distant metastasis cannot be evaluated, M0 denotes that there is no distant metastasis, and M1 indicates that distant metastasis is present (National Cancer Institute, 2014). Although, most types of cancer uses TNM assessment system to stage the intensity of the cancer, particular staging criteria may vary with tumors in different organ system, such as breast cancer (Copstead, Banasik, 2010). The outcomes of the staging process will govern the choice of cancer treatment. The surgery, radiation therapy, or chemotherapy may be used, separately or in combination to destroy the cancer cells. Confined local tumors may be treated with surgery and radiation therapy; however indication of metastasis would require inclusion of chemotherapy in the treatment regimen (Copstead, Banasik, 2010). Complications Complications resulting from this life threatening disease are as diverse as the numerous types of cancer itself. The severity may vary from person to person depending on the patients’ health status, stage of cancer and area or organ affected. The complications could be divided in two broad categories, such as physical and psychological complications. Physical Complications Among various physical complications pain is the most feared complication of the disease process. The mechanism of pain could relate directly to the disease itself or indirectly due to the treatment and procedures. Cancer pain may arise due to direct pressure, obstruction, invasion of metastatic cells into organs or bone, tissue destruction, and inflammation (Copstead, Banasik, 2010). The treatment and procedures such as biopsies and intravenous therapy may become additional contributing factors for pain (Copstead, Banasik, 2010). Providing adequate pain management and support for associated symptoms is a main responsibility of the healthcare team. Pain management needs to be individualized based on patient’s pain perception and response. Patients should be encouraged to report pain, but at the same time the healthcare professional needs to be mindful of social and cultural implications with respect to pain perception. Pain management  includes administration of analgesics as needed or on scheduled basis, providing options for patient-controlled analgesia, non- pharmacological interventions such as meditation, and managing activities to minimize pain (Copstead, Banasik, 2010). Another complication of cancer is bone marrow suppression which leads to anemia, leukopenia, and thrombocytopenia. The cause of bone marrow suppression could be invasion and destruction of blood-forming cells in the bone marrow, poor nutrition, and chemotherapeutic drugs (Copstead, Banasik, 2010). Anemia denotes to deficient circulating red blood cells. The signs and symptoms manifested by a patient may include fatigue, tachycardia, and tachypnea due to decreased oxygen-carrying capacity. Leukopenia refers to reduction in white blood cells in circulation. This jeopardizes a patient’s capability to combat infections, thus becoming a major factor for poor prognosis. The patient may demonstrate signs and symptoms of infection such as fever, chills, cough, or diarrhea. Thrombocytopenia signifies a deficit in circulating platelets, which could lead to fatal hemorrhaging. The patient could manifest signs and symptoms of bleeding such as bruises, hematuria, etc. These issues are managed by administration of blood products. In selected situations, growth factors, such as erythropoietin (Epogen) or granulocyte-stimulating factors (Neupogen), are also administered to improve the production of red and white blood cells (Copstead, Banasik, 2010). Side Effects of Treatment Surgery Surgery is the first option for patients with solid, localized tumors. In addition to providing samples for biopsy, it could be curative if the cancer is detected at an early stage. In high risk population, it is also used as a preventative intervention. Surgical intervention contains potential risks related to administration of anesthesia, risk of infection, and blood loss. Additionally, it may cause disfigurement or cause loss of function leading to physical and psychological issues (Copstead, Banasik, 2010). Depending on the issue, patients could be provided pharmacological support in case of pain and infection and counseling for psychological concerns. For prevention of infection proper wound management is necessary. Additionally provision of  prosthesis, wigs and other such supplies could help patient cope issues of altered self-image. Chemotherapy Chemotherapy entails systemic administration of anticancer chemicals as treatment for cancers. The chemotherapy drugs are cytotoxic, as they inhibit some aspect of cell division. It requires several courses of drug therapy to ensure that all tumor cells have been killed. During the therapy, normal cells are also destroyed, in particular: rapidly dividing cells of the bone marrow, intestinal epithelia, and hair follicles (Copstead, Banasik, 2010). The patient may manifest signs and symptoms such as nausea, vomiting, hair loss, memory change, fatigue, infection, bleeding, mouth and throat changes, sexual dysfunction, and pain (National Cancer Institute, 2012). Educating patients about the potential side effects and providing treatment and support as the symptoms are manifested would be the key element to assist patient during the course of treatment for better compliance. Methods to Lessen Physical and Psychological Effects According to Payne and Donaghy (2010) there is close interaction between somatic, cognitive and behavioral processes. For example any physical problem such as pain may give rise to psychological issues such as anxiety and behavioral concerns such as lack of participation in activities to avoid pain. Thus, therapeutic intervention requires unified integration of varying strategies addressing different elements in care for these patients. To cope with psychological and behavioral issues, social, emotional and professional support is crucial for a patient. This support would enable patient to deal from normal adjustment issues as well as adjustment disorders. Patients can gain knowledge and training to cope with psychological stress through various approaches. Some of the approaches are training in relaxation, meditation, or stress management; counseling or talk therapy; cancer education session; social support in group setting; exercise, and medication for depression or anxiety (National Cancer Institute, n. d. ). There are various government and non-government organizations committed to assist cancer patients and their families such as American Cancer Society. A patient could seek support from these organizations as well. To minimize physical effects of treatment pharmacological and non-pharmacological interventions could be adopted. Providing detail information before initiation of treatment about side effects would alleviate anxiety to knowledge deficit. Educating patient how to deal with physical effects will increase confidence and give them feeling of control over their situation. The most common side effect of chemotherapy is nausea and vomiting. Usually patients are given antiemetic to minimize this issue. In addition patient should be provided with nutritional consultation to modify diet. Patient should be educated to take small nutritious meals and avoid foods that are hard to digest. Another side effect is leukopenia that predisposes patient to infection. Depending on patient’s WBC count, a patient may require reverse isolation or education how to prevent infection. A patient should be instructed to maintain good personal and environmental hygiene, avoid going out in public places during course of treatment, avoid direct contact with family or friends who cold or other infection, and maintain food hygiene. Fatigue due to radiation therapy or anemia could be minimized by taking short naps of less than an hour in day time, balancing period of activity with rest, getting adequate sleep at least 8 hours, eating and drinking well and doing little exercise every day (National Cancer Institute, n. d. ). To deal with issue of pain after surgery patient could be given opioid analgesics and taught relaxation techniques such as imaginary, listening to music and or meditation. Conclusion Cancer is a life threatening illness which affects individuals of all ages. The diagnosis and treatment modalities could have serious physical, psychological and social implications. Therefore, individuals require ongoing support from the healthcare professionals, family, friends, and the society for their survival. It is important to educate patient in minimizing and dealing with side effects of treatment. There are numerous government and non-government resources available for patient education and support. Knowledge of these resources can assist healthcare professionals in directing patient to these resources and improve patient outcomes.

Definition and Examples of Creoles

Definition and Examples of Creoles In linguistics, a creole is a type of  natural  language that developed historically from a pidgin and came into existence at a fairly precise point in time.  English creoles are spoken by  some of the people in  Jamaica, Sierra Leone, Cameroon, and  parts of Georgia and South Carolina. The historical  transition from a pidgin to a creole is called creolization.  Decreolization is the process by  which a creole language gradually becomes more like the standard language of a region (or the acrolect). The language that provides a creole with most of its vocabulary is called the lexifier language. For example, the lexifier language of Gullah (also called  Sea Island Creole English) is English.   Examples and Observations of Creole Creolization-  A pidgin is the combination of two or more languages which sometimes occurs in trade contact, multi-ethnic or refugee situations, where participants need a functioning common language. . . . Sometimes the pidgin becomes stable and established and comes to be spoken as a mother-tongue by children: the language has then become a creole, which quickly develops in complexity and is used in all functional settings. The process of turning a pidgin into a creole is called ​creolization.(Robert Lawrence Trask and Peter Stockwell, Language and Linguistics: The Key Concepts. Routledge, 2007)-   A creole has a jargon or a pidgin in its ancestry; it is spoken natively by an entire speech community, often one whose ancestors were displaced geographically so that their ties with their original language and sociocultural identity were partly broken. Such social conditions were often the result of slavery.(John A. Holm, An Introduction to Pidgins and Creoles. Cambridge Univ ersity Press, 2000) Similar Features of CreolesLinguists have been struck by the similarities between widely separated creoles. These include such features as SVO word order, pre-verbal negation, lack of a formal passive voice, questions with the same forms as statements, and copula deletion. Some linguists argue that such similarities are evidence of an innate language faculty or bioprogram- that in conditions of impoverished linguistic input, children will nevertheless develop a fully fledged syntax based on universal grammar.(Michael Pearce, The Routledge Dictionary of English Language Studies. Routledge, 2007)Gullah-  The English variety spoken by descendants of Africans on the coast of South Carolina is known as Gullah and has been identified as a creole. Of all the vernaculars associated with African Americans, it is the one that diverges the most from (White) middle-class varieties in North America.(S.S. Mufwene, North American Varieties of English as Byproducts of Population Contacts, in The W orkings of Language, ed. by R. S. Wheeler. Greenwood, 1999)- On possible to get straight wood from crooked timber.(A Gullah  proverb,  from  The Gullah People and Their African Heritage, 2005)- The Gullah lexicon is  largely English. From his research conducted in the late 1930s, Lorenzo Turner was the first linguist to document over 4000 Africanisms in the Gullah lexicon,  many of them used as basket names (e.g. Gullah nicknames). Today you can still hear in normal everyday conversations such African retentions as  buckra white man, tita elder sister, dada mother or elder sister, nyam eat/meat, sa quickly, benne sesame, una you, and da the verb to be.  Other Gullah Africanisms such as  cooter turtle, tote to carry, okra plant food, gumbo stew, and goober peanut are widely used in mainstream American English.(Concise Encyclopedia of Languages of the World, ed. by  Keith Brown and Sarah Ogilvie.  Elsevier, 2009 Disagreements Over the Creole Roots of Black English in the U.S.[A]s for various arguments that Black English displays African or creole roots because of the role that aspect plays in its grammar (e.g., DeBose and Faraclas 1993), the issue is in fact not yet sufficiently examined to stand as an accepted fact. For one, tense plays a much more central role in Black English grammar than in Creoles or the West African languages of the Upper Guinea region, underlyingly marking the past and future as obligatorily as any Indo-European grammar (cf. also Winford 1998: 116). Second, typical of Creolist Hypothesis advocates generally insufficient attention to English dialects, the aspect arguments do not address the role that aspect in nonstandard British dialects may have played. This gap in argumentation alone renders the linkage of Black English aspect to Africa and creoles seriously incomplete, which is all the more significant given that there is indeed evidence that nonstandard British di alects are more aspect-focused than standard English (Trugdill and Chambers 1991).(John H. McWhorter, Defining Creoles. Oxford University  Press, 2005) Pronunciation: KREE-ol

Unit Assessment 5 professionalism Essay Example | Topics and Well Written Essays - 500 words

Unit Assessment 5 professionalism - Essay Example In my company where gifts are not encouraged, I would accept for any gifts offered but work towards ensuring that policies of the organization are well understood to ensure that the person does not offer gifts in the future. The fact that the employee has been offering gifts for a long time may indicate two things. Firstly, the employee may not be aware of the policy regarding gifts (DuPont, 1998). Secondly, he/she may just be ignorant and not care of the consequences of going against the organizational policies. To address these issues, I would strive to have the organizational policies understood by all the staff members by sharing on their emails as well as through communication through supervisors. This way, the employee targeted will not feel victimized and will most likely stop the act. The other step that may be taken is through training to all staff members on different policies as well as offering written policies upon signing of contracts for new employees (Malin, 2000). In the event that such measure do no work on an employee, it is important to communicate the policy to the affected employee directly to ensure that they stop the habit from becoming widespread within the organization against the policies. Â   Motivation is important in ensuring that staff members work and deliver maximally in an organization. As a supervisor, working with a motivated group makes it easy to achieve organizational goals. It also reduces many problems, which may arise from internal conflicts, lack of communication and poor performance (DuPont, 1998). One of the most important methods of motivating employees is through offering a nurturing environment at the work place. A nurturing environment makes employees feel that they are cared for and that their welfare is well considered by the organization (Anderson and Bolt, 2011). For instance offering free counseling services for employees may be a good step towards a