Rebuttal Definition, Usage and Examples

A rebuttal takes on a couple of different forms. As it pertains to an argument or debate, the definition of a rebuttal is the presentation of evidence and reasoning meant to weaken or undermine an opponents claim. However, in persuasive speaking, a rebuttal is typically part of a discourse with colleagues and rarely a stand-alone speech. Rebuttals are used in law, public affairs, and politics, and theyre in the thick of effective public speaking. They also can be found in academic publishing, editorials, letters to the editor, formal responses to personnel matters, or customer service complaints/reviews. A rebuttal is also called a  counterargument. Types and Occurrences of Rebuttals Rebuttals can come into play during any kind of argument or occurrence where someone has to defend a position contradictory to another opinion presented. Evidence backing up the rebuttal position is key. Academics Formally, students use rebuttal in debate competitions. In this arena, rebuttals dont make new arguments, just battle the positions already presented in a specific, timed format. For example, a rebuttal may get four minutes after an argument is presented in eight. Publishing In academic publishing, an author presents an argument in a paper, such as on a work of literature, stating why it should be seen in a particular light. A rebuttal letter about the paper can find the flaws in the argument and evidence cited, and present contradictory evidence. If a writer of a paper has the paper rejected for publishing by the journal, a well-crafted rebuttal letter can give further evidence of the quality of the work and the due diligence taken to come up with the thesis or hypothesis. Law In law, an attorney can present a rebuttal witness to show that a witness on the other side is in error. For example, after the defense has presented its case, the prosecution can present rebuttal witnesses. This is new evidence only and witnesses that contradict defense witness testimony. An effective rebuttal to a closing argument in a trial can leave enough doubt in the jurys minds to have a defendant found not guilty. Politics In public affairs and politics, people can argue points in front of the local city council or even speak in front of their state government. Our representatives in Washington present diverging points of view on bills up for debate. Citizens can argue policy and present rebuttals in the opinion pages of the newspaper. Work On the job, if a person has a complaint brought against him to the human resources department, that employee has a right to respond and tell his or her side of the story in a formal procedure, such as a rebuttal letter. Business In business, if a customer leaves a poor review of service or products on a website, the companys owner or a manager will, at minimum, need to diffuse the situation by apologizing and offering a concession for goodwill. But in some cases, a business needs to be defended. Maybe the irate customer left out of the complaint the fact that she was inebriated and screaming at the top of her lungs when she was asked to leave the shop. Rebuttals in these types of instances need to be delicately and objectively phrased. Characteristics of an Effective Rebuttal If you disagree with a comment, explain the reason, says  Tim Gillespie in Doing Literary Criticism.  He notes that mocking, scoffing, hooting, or put-downs reflect poorly on your character and on your point of view. The most effective rebuttal to an opinion with which you strongly disagree is an articulate counterargument. Rebuttals that rely on facts are also more ethical than those that rely solely on emotion or diversion from the topic through personal attacks on the opponent. That is the arena where politics, for example, can stray from trying to communicate a message into becoming a reality show. With evidence as the central focal point, a good rebuttal relies on several elements to win an argument, including a clear presentation of the counterclaim, recognizing the inherent barrier standing in the way of the listener accepting the statement as truth, and presenting evidence clearly and concisely while remaining courteous and highly rational. The evidence, as a result, must do the bulk work of proving the argument while the speaker should also preemptively defend certain erroneous attacks the opponent might make against it. That is not to say that a rebuttal cant have an emotional element, as long as it works with evidence. A statistic about the number of people filing for bankruptcy per year due to medical debt can pair with a story of one such family as an example to support the topic of health care reform. Its both illustrative — a more personal way to talk about dry statistics — and an appeal to emotions. Preparing To prepare an effective rebuttal, you need to know your opponents position thoroughly to be able to formulate the proper attacks and to find evidence that dismantles the validity of that viewpoint. The first speaker will also anticipate your position and will try to make it look erroneous. You will need to show: Contradictions in the first argumentTerminology thats used in a way in order to sway opinion (bias) or used incorrectly. For example, when polls were taken about Obamacare, people who didnt view the president favorably were more likely to want the policy defeated than when the actual name of it was presented as the Affordable Care Act.Errors in cause and effectPoor sources or misplaced authorityExamples in the argument that are flawed or not comprehensive enoughFlaws in the assumptions that the argument is based onClaims in the argument that are without proof or are widely accepted without actual proof. For example, alcoholism is defined by society as a disease. However, there isnt irrefutable medical proof that it is a disease like diabetes, for instance. Alcoholism manifests itself more like behavioral disorders, which are psychological. The more points in the argument that you can dismantle, the more effective your rebuttal. Keep track of them as theyre presented in the argument, and go after as many of them as you can. Refutation Definition The word rebuttal can be used interchangeably with refutation, which includes any contradictory statement in an argument. Strictly speaking, the distinction between the two is that a rebuttal must provide evidence, whereas a refutation merely relies on a contrary opinion. They differ in legal and argumentation contexts, wherein refutation involves any counterargument, while rebuttals rely on contradictory evidence to provide a means for a counterargument. A successful refutation may disprove evidence with reasoning, but rebuttals must present evidence.

Analysis Of Aldous Huxley s Brave New World - 2114 Words

In its essence, the caste system is defined as a system of social stratification, sorting individuals into a number of endogamous castes, each with predestined customs and obligations. The juxtaposition of the traditional caste system and stability in a contemporary society is unorthodox and seemingly nonsensical at first glance. However, in observing the caste system in its application today, one would argue in terms of stability at least, that it operates at a much higher degree of effectiveness than the common Western social structure. The fictional World State portrayed in Aldous Huxley s Brave New World serves as a testament to the potential efficacy of such a mandated caste system in postmodern society. The caste system serves†¦show more content†¦Historian H.T Buckle brings forward such a principle in his paper â€Å"A History of Civilization in Britain† formulated as such: â€Å"If a system provides its parts with an optimum environment, they will tend to con serve it. Thusly, for an individual to strive to conserve the social system of which he is part, the latter must provide the outlets which will enable him to fulfill those functions for which he was culturally and genetically designed.†(Buckle, Vol. 1) Huxley’s World State does just this, as each caste comes gilded with its own responsibilities: As the Epsilon caste is tasked with menial labor and the Alpha caste is tasked with social development and government. Each caste member contributes to these tasks productively as he is surrounded by others doing the same; as made evident in the novel excerpt: â€Å"Everyone belongs to everyone else.†(Huxley, 3.138) a hypnopaedic utterance recited by portrayed scientist Henry Foster in an effort to encourage his colleague (Lenina Crowne) in her promiscuity. The feeling of self-worth brought about by community in a caste is an indispensable variable when regarding the stability of said caste. When his self-worth depreciat es, the individual becomes dissatisfied with his circumstance, seeking an alternate one; this hinders the system (World State) as it breeds rebellious thoughts. In Brave New World, such a phenomenon is observed in analyzing the novel s

Exploring the 1960’s Free Essays

As an archeologist I have seen many things while traveling the world. But I recently came across an interesting time capsule in Cedar Rapids, Iowa. I would have never thought the 60’s were an eventful decade, since it was way before my time, but boy was I amazed at what I found. We will write a custom essay sample on Exploring the 1960’s or any similar topic only for you Order Now The invention and distribution of birth control pills gave a new freedom to women and their sexuality. The assassination of John Fitzgerald Kennedy, a young president that had a promising future, along with many other high profile men who had a large support following. Woodstock in upstate New York 1969 was a huge event that spawned many other festivals featuring several day events and equally rowdy crowds throughout the U. S. And my all-time favorite movie, debuted in 1968, George Romero’s Night of the Living Dead. In centuries past there have been many forms of birth control. In Egypt 1550 B. C, women would mix berries, herbs and honey as a vaginal suppository to kill sperm during intercourse. 1700’s Giovanni Casanova, and Italian adventurer and author, attempted a form of female condom with sheep intestine and lemon juice. In 1839, Charles Goodyear who vulcanized rubber, created the first true condom, douche syringes, and a womb veil or a form of a diaphragm, which was later officially called a diaphragm in 1880. But, it was not until 1960 that the first birth control pill, Envid was created, and almost half a million women were taking it for actual medical purposes other than a form of not getting pregnant. The creation of the birth control pill allowed a new freedom for women to explore their sexuality and not get pregnant, but it did not and still does not prevent sexually transmitted diseases. John Fitzgerald Kennedy, born on May 29, 1917, was not a very healthy child. Suffering from typically ailments such as whooping cough, chicken pox, and measles, almost did not make it after a battle with scarlet fever before the age of 3. He grew up as an Irish Catholic in Massachusetts. Though a sickly and slightly clumsy kid, being one of nine kids, he had a very dominant personality. In 1936 he entered Harvard University playing football alongside his older brother Joe; however he was not as good of a player as his brother and suffered a back injury that would never fully heal. His brother Joe was the one with the aspirations to become the first Irish President. His senior year at Harvard, he wrote his thesis based on why Great Britain was not ready to take on Germany. It was later published, called Why England Slept. Joining the Navy after graduating, he served as Captain on a PT-109 to keep the Japanese from delivering supplies to their soldiers. He was awarded the Medal of Honor from both the Navy and Marine Corps for his courage and bravery after a Japanese destroyer rammed the ship he was on, splitting it in 2, killing two of the twelve crew members. JFK rescued one of his shipmates who was severely burned, as well as the rest of the crew when he wrote a note on a coconut shell that was found by natives days later. In 1946, after his service time, he ran for congress in Massachusetts and won a seat. He went on to serve 3 terms and was then elected to the Senate. He wrote a book in 1957 regarding U. S. Senators who fought for what they believed in called Profiles of Courage, which won him a Pulitzer Prize. On July 13, 1960 he was nominated by the Democratic Party to run for President of the United States, making him the youngest President (43), and was elected the 35th President on January 20, 1961. On November 22, 1963 John Fitzgerald Kennedy, also known as Jack, was riding in a motorcade on his way to a luncheon when he was hit in the head and neck passing by the Texas School Depository in Dallas, Texas. Also hit was the Governor, who later recovered from his serious chest wound. John F. Kennedy was an advocate for fighting poverty, racial discrimination, disease, war and wanted to be the first country to put a man on the moon. His assassin, Lee Harvey Oswald, who also killed a police officer the same day, was himself assassinated by Jack Ruby, silencing the only man who could answer questions as to why Kennedy was killed. The assassination of JFK has been a controversial topic for many years and until any documents and or photos come to light on who or what was behind his assassination we may never know. Kennedy was a big pusher for space exploration, and though he was not present to see his dream come true, on July 16, 1969, a team of three men were catapulted into space to be the first men on the moon. There have been many speculations as to whether this event even happened, even though there is video footage of the event, many question if it was actually just filmed on a Hollywood back lot. Since that first landing there has not been another U. S. man or woman on the moon, but there have been many who have entered space for further exploration, and it is expected that there will once again be a man/woman on the moon in the future, but for a longer period of time. Music makes the world go round. No matter what race, religion, gender or age, music can make us smile, laugh, love, cry, or calm us down. So what could bring the world together to send a message of peace, cultural expression, and openness? In 1969, more than half a million people travelled to Bethel, NY for a music festival that made sure many generations would be heard. In August 1969, over a 4 day period of time, 32 acts performed on a 600 acre dairy farm to bring awareness regarding the environment, universal human rights, free trade, and creative expression among other things. Performances by the great artists like Jimi Hendrix, the Who, Creedance Clearwater Revival and Crosby, Stiles and Nash. Many other music festivals have been established over the years but none have rivaled the original. The Woodstock Festival has been repeated two more times over the years, once in 1994 featuring bands such as repeat performer Joe Cocker, new bands of the time like Blues Travelers, as well as established bands like Metallica, Aerosmith, and also a repeat performance by Crosby, Stiles and Nash. Again, five years later, featuring Punk bands such as George Clinton and the P. Funk Band, The Offspring, and many others. Still maintaining the education of the importance of keeping our earth clean, trade among countries, and the importance of creative expression. Another form of expression is filmography. Over the years there have been a variety of movies created for our entertainment from comedy, drama, science fiction, documentaries, action and my favorite, horror. In my opinion, one of the best horror movies created was in 1968. George Romero’s Night of the Living Dead was awesome. Writer and Director George Romero went on to write many other horror movies after Night of the Living Dead, such as The Crazies (1973), Dawn of the Dead (1978), Day of the Dead (1985), the screen play for Stephen Kings Monkey Shines (1988), and two remakes of Dawn of the Dead (2004) and The Crazies (2010). The original Night of the Living Dead, did not have a well- known cast, and they did not go on to have a lucrative movie careers. The storyline is of siblings Barbara and Johnny traveling to Pennsylvania to visit the gravesite of their father. Attacked on their trip by a strange individual, Johnny is killed and Barbara runs to a nearby abandoned farmhouse or so she believes. Inside, she meets Ben, who is also trying to escape the unusual creatures that are attempting to attack them. Survival becoming key, they search the house for items they can use to keep themselves safe. Upon their search, they find a radio, and able find a working radio station they find out that radiation from a satellite that returned to Earth from Venus, is affecting the dead, and reanimating them, however it causes them to attack the living. Over the decades since the original screenplay, it has been reworked by many, but nothing Romero’s by far is my favorite. Our future is ever changing and if we have learned anything since the beginning of time is progress is important for an ever evolving world. Upon discovering the time capsule from the 1960’s, I am getting a better realization on how important change is to our future. The evolution of birth control, from Egyptians using an all-natural vaginal suppository to the creation of the pill to give women a freedom to have more sexual experiences without the consequences of pregnancy. The progress John F Kennedy tried to push, space exploration, a peaceful cohabitation between cultures and races within the United States and trying to make a difference in the poverty stricken areas in the U. S. Being the first country to put men on the moon and constantly exploring the universe, perhaps we are not the only ones here. And exploring the infinite creativeness of music and film, the possibilities are endless. How to cite Exploring the 1960’s, Papers Exploring the 1960’s Free Essays As an archeologist I have seen many things while traveling the world. But I recently came across an interesting time capsule in Cedar Rapids, Iowa. I would have never thought the 60’s were an eventful decade, since it was way before my time, but boy was I amazed at what I found. We will write a custom essay sample on Exploring the 1960’s or any similar topic only for you Order Now The invention and distribution of birth control pills gave a new freedom to women and their sexuality. The assassination of John Fitzgerald Kennedy, a young president that had a promising future, along with many other high profile men who had a large support following. Woodstock in upstate New York 1969 was a huge event that spawned many other festivals featuring several day events and equally rowdy crowds throughout the U. S. And my all-time favorite movie, debuted in 1968, George Romero’s Night of the Living Dead. In centuries past there have been many forms of birth control. In Egypt 1550 B. C, women would mix berries, herbs and honey as a vaginal suppository to kill sperm during intercourse. 1700’s Giovanni Casanova, and Italian adventurer and author, attempted a form of female condom with sheep intestine and lemon juice. In 1839, Charles Goodyear who vulcanized rubber, created the first true condom, douche syringes, and a womb veil or a form of a diaphragm, which was later officially called a diaphragm in 1880. But, it was not until 1960 that the first birth control pill, Envid was created, and almost half a million women were taking it for actual medical purposes other than a form of not getting pregnant. The creation of the birth control pill allowed a new freedom for women to explore their sexuality and not get pregnant, but it did not and still does not prevent sexually transmitted diseases. John Fitzgerald Kennedy, born on May 29, 1917, was not a very healthy child. Suffering from typically ailments such as whooping cough, chicken pox, and measles, almost did not make it after a battle with scarlet fever before the age of 3. He grew up as an Irish Catholic in Massachusetts. Though a sickly and slightly clumsy kid, being one of nine kids, he had a very dominant personality. In 1936 he entered Harvard University playing football alongside his older brother Joe; however he was not as good of a player as his brother and suffered a back injury that would never fully heal. His brother Joe was the one with the aspirations to become the first Irish President. His senior year at Harvard, he wrote his thesis based on why Great Britain was not ready to take on Germany. It was later published, called Why England Slept. Joining the Navy after graduating, he served as Captain on a PT-109 to keep the Japanese from delivering supplies to their soldiers. He was awarded the Medal of Honor from both the Navy and Marine Corps for his courage and bravery after a Japanese destroyer rammed the ship he was on, splitting it in 2, killing two of the twelve crew members. JFK rescued one of his shipmates who was severely burned, as well as the rest of the crew when he wrote a note on a coconut shell that was found by natives days later. In 1946, after his service time, he ran for congress in Massachusetts and won a seat. He went on to serve 3 terms and was then elected to the Senate. He wrote a book in 1957 regarding U. S. Senators who fought for what they believed in called Profiles of Courage, which won him a Pulitzer Prize. On July 13, 1960 he was nominated by the Democratic Party to run for President of the United States, making him the youngest President (43), and was elected the 35th President on January 20, 1961. On November 22, 1963 John Fitzgerald Kennedy, also known as Jack, was riding in a motorcade on his way to a luncheon when he was hit in the head and neck passing by the Texas School Depository in Dallas, Texas. Also hit was the Governor, who later recovered from his serious chest wound. John F. Kennedy was an advocate for fighting poverty, racial discrimination, disease, war and wanted to be the first country to put a man on the moon. His assassin, Lee Harvey Oswald, who also killed a police officer the same day, was himself assassinated by Jack Ruby, silencing the only man who could answer questions as to why Kennedy was killed. The assassination of JFK has been a controversial topic for many years and  until any documents and or photos come to light on who or what was behind his assassination we may never know. Kennedy was a big pusher for space exploration, and though he was not present to see his dream come true, on July 16, 1969, a team of three men were catapulted into space to be the first men on the moon. There have been many speculations as to whether this event even happened, even though there is video footage of the event, many question if it was actually just filmed on a Hollywood back lot. Since that first landing there has not been another U. S. man or woman on the moon, but there have been many who have entered space for further exploration, and it is expected that there will once again be a man/woman on the moon in the future, but for a longer period of time. Music makes the world go round. No matter what race, religion, gender or age, music can make us smile, laugh, love, cry, or calm us down. So what could bring the world together to send a message of peace, cultural expression, and openness? In 1969, more than half a million people travelled to Bethel, NY for a music festival that made sure many generations would be heard. In August 1969, over a 4 day period of time, 32 acts performed on a 600 acre dairy farm to bring awareness regarding the environment, universal human rights, free trade, and creative expression among other things. Performances by the great artists like Jimi Hendrix, the Who, Creedance Clearwater Revival and Crosby, Stiles and Nash. Many other music festivals have been established over the years but none have rivaled the original. The Woodstock Festival has been repeated two more times over the years, once in 1994 featuring bands such as repeat performer Joe Cocker, new bands of the time like Blues Travelers, as well as established bands like Metallica, Aerosmith, and also a repeat performance by Crosby, Stiles and Nash. Again, five years later, featuring Punk bands such as George Clinton and the P. Funk Band, The Offspring, and many others. Still maintaining the education of the importance of keeping our earth clean, trade among countries, and the importance of creative expression. Another form of expression is filmography. Over the years there have been a variety of movies created for our entertainment from comedy, drama, science fiction, documentaries, action and my favorite, horror. In my opinion, one of the best horror movies created was in 1968. George Romero’s Night of the Living Dead was awesome. Writer and Director George Romero went on to write many other horror movies after Night of the Living Dead, such as The Crazies (1973), Dawn of the Dead (1978), Day of the Dead (1985), the screen play for Stephen Kings Monkey Shines (1988), and two remakes of Dawn of the Dead (2004) and The Crazies (2010). The original Night of the Living Dead, did not have a well- known cast, and they did not go on to have a lucrative movie careers. The storyline is of siblings Barbara and Johnny traveling to Pennsylvania to visit the gravesite of their father. Attacked on their trip by a strange individual, Johnny is killed and Barbara runs to a nearby abandoned farmhouse or so she believes. Inside, she meets Ben, who is also trying to escape the unusual creatures that are attempting to attack them. Survival becoming key, they search the house for items they can use to keep themselves safe. Upon their search, they find a radio, and able find a working radio station they find out that radiation from a satellite that returned to Earth from Venus, is affecting the dead, and reanimating them, however it causes them to attack the living. Over the decades since the original screenplay, it has been reworked by many, but nothing Romero’s by far is my favorite. Our future is ever changing and if we have learned anything since the beginning of time is progress is important for an ever evolving world. Upon discovering the time capsule from the 1960’s, I am getting a better realization on how important change is to our future. The evolution of birth control, from Egyptians using an all-natural vaginal suppository to the creation of the pill to give women a freedom to have more sexual experiences without the consequences of pregnancy. The progress John F Kennedy tried to push, space exploration, a peaceful cohabitation between cultures and races within the United States and trying to make a difference in the poverty stricken areas in the U. S. Being the first country to put men on the moon and constantly exploring the universe, perhaps we are not the only ones here. And exploring the infinite creativeness of music and film, the possibilities are endless. How to cite Exploring the 1960’s, Papers

Multiple Personality Disorders Essay Example For Students

Multiple Personality Disorders Essay Multiple Personality Disorders By Philip AushermanMultiple Personality Disorder (MPD) or Dissociative Identity Disorder (DID) was first recognized in the 1700s but was not understood so therefore it was forgotten. Many cases show up in medical records through the years, but in 1905, Dr. Morton Prince wrote a book about MPD that is a foundation for the disorder. A few years after it was published Sigmund Freud dismissed the disorder and this dropped it from being discussed at any credible mental health meetings. Since then the disorder has been overlooked and misdiagnosed as either schizophrenia or psychosis. Many in the medical profession did not believe that a person could unknowingly have more than one personality or person inside one body, even after the 1950s Three Faces of Eve was published by two psychiatrist. In 1995, records showed that three to five thousand patients were being treated for MPD compared to the hundred cases reported ten years earlier. There is still as increa se in the number of cases being reported as the scientific community learns more and more about the disease and the public is becoming more and moreaware of this mental disorder. There are still many questions left unanswered about the disease, like Is it genetic? or Is a certain type of personality more vulnerable to the disorder? but many aspects of how people come by the disorder are already answered (Clark, 1993, p.17-19) MPD is commonly found in adults who were recurrently abused mentally, physically, emotionally, and/or sexually as young children, between birth to 8 years of age. The child uses a process called dissociation to remove him/herself from the abusive situation. Dissociation is when a child makes up an imaginary personality to take control of the mind and body while the child is being abused. The child can imagine many personalities but usually there is a personality for every feeling and or emotion that was involved during the abuse (BoyyM, 1998, p.1). As an adult, the abused child finds it hard to keep track of time and may have episodes of amnesia. Other symptoms that will appear in adults with MPD are depression, auditory and visual hallucinations (hearing voices) and suicidal thoughts. Another major symptom is when the adult has no recollection of their childhood. The adult with MPD has no idea they were abused as children and also unaware of the other personalities living inside of their head (Multiple Personality Disorder-fact sheet, 1996-99, p.1). Multiple Personality Disorder is when there is the presence of two or more distinct identities or personalities, each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self(BoyyM, 1998, p.1). There can be anywhere from two to over a hundred different personalities. Usually each personality will fall into one of the following categories: core, host, protectors, internal self-helper, fragments, child members, preteen, teenager, adults, a rtistic/music, cross-gender, cross-colored, animal members, inanimate members (BoyyM, 1998, p. 2-3). The host personality is the person who is the multiple, this is the original personality, or the one that created the other personalities, but is unaware of them. The most common apparent identities are the child, persecutor, rescuer, and helper. The child is the identity that is under the age of twelve. They behave as children often sucking thumbs, twisting hair, like to eat cookies, throw tantrums, and use child-like vocabulary. The Persecutor identity is the self-destructive identity that is violent and angry. Persecutor identities usually have a drug/alcohol problem and generally put the host at risk. The rescuer personality is usually devoid of emotion but logical, able, proficient, and responsible. The helper personality knows the most about the history of the multiple; they generally want to help everyone for the general good. The helper personality is the personality that is most helpful in therapy because they usually know about all the other identities (Clark, 1993, p.80-83). Subpersonalities are not only part of a person with MPD but they are also evident in emotionally normal persons as well. Although, in a normal person, he/she remembers when their subpersonality takes over, but in a MPD patient, the personality disconnects from the host that the host can not remember what happens. When a traumatic experience happens, whether positive or negative, a subpersonality will develop. In a normal person, the splitting is broken into an ok self and a not ok self. In a multiple, the personalities are more defined; they are broken into smaller fragments that disassociate from the human host (Rowan, 1990, p. 7, 20). In the book by Terri A. Clark, M.D., it shows the distinct the personalities are in several cases. It also shows how each identity can be different from the other identities and the host. In one of Clarks cases, Veronica, one of the personalities of her patient Regina, showed up for the weekly appointment instead of Regina (note that it really was Regina, but she was a different identity). Clark noticed a change in the appearance of Regina on her arrival and noted the difference in her voice. Veronica (Regina) continued to speak to Clark as if it was the first time they had met. Although, Veronica knew about Clark, Reginas personal life, and therapy, this was the first time Clark had met this personality. Clark discovered while talking to Veronica that she had a separate business which she ran on the weekends, and when Veronica was in control of the body. Regina had no idea about the business; Veronica used the fake name and an Art Gallerys telephone number in which to run her business. Veronica even had a different handwriting than Regina. According to Clark, each personality has its own distinct features, such as handwriting, fashion taste, hobbies, and culinary taste. In most cases, there will always be personality that w rites with their left hand, while the host and other identities write with their right. In Reginas case, Veronica wore different clothes than Regina and she had an interest in fine art. Each personality of a host, when asked, will tell you they have a certain type of hair color and cut, height, weight, and even gender (Clark, 1993, p. 73-78). The problem with having all these personalities is that they do not mesh well. Consequences can arise from having so many different traits inside one body like eating and sleep disorders, depression, anxiety, and substance abuse (Smith, 1993, p.1). Each alter also has their own name, these names can come from anything but there are three common factors that influence the alters name. Some alters are just born with the name, this is when the alter is modeled after a real or fictional character. Some alters are named after emotional responses, such as Sad One or Angry Janie. Many alters are named for the specific job they are supposed to do, like Director, Helper or Avenger. The names chosen have been created by a child so they are most likely modeled after a fictional or real character. Although the host will have no idea of the other personalities and will not respond to the names at first, the alters respond to the birth personalities name (Clark, 1993, 90-91). The circumstances that the identities get the host into can also become a problem. The different alters while in possession of the body can go somewhere where the host does not know and then leave and the host is left with no idea how he/she got there and how to get back. In Sybil, one of the first times she realized she had a problem was when she had to leave her Columbia University Chemistry Lab when something broke. The last thing she remembered was standing at the elevator but when she regained consciousness she was in the warehouse district of Philadelphia. Miles from where she had been before in New York and it was five days later (Schreiber, 1973, p. 23-36) . The persecutor identity has a tendency to leave the host in dangerous situations. Carla, one of Clarks patients, had a persecutor alter named Godiva. Godiva was always putting Carla in sticky situations like Godiva would pick up men at bars and bring them home or go home with them. Carla would come to consciousness with an unknown man in her bed and she would pass out, another alter would have to come out and rescue Carla. CJ (Carlas big burly male alter) would come out punch the guy and leave. Christine (Carlas logical alter) would come out and handle the situation using her negotiation skills. At other times Timmy (the young boy who was an escape artist) would come out talk his way out of the situation, leaving the man so bewildered because he was with a woman who thought she was a young boy. When this occurred it would leave the other alters upset at Godiva (Clark, 1993, p.99). There are three different types of relationships that alters can have between each other. The first o ne is, one-way amnesia, this is when alter number one knows about alter number two but alter number two does not know about number one. The second relationship is two-way amnesia exist when neither alter know about each other(Clark, 1993, p. 87). Cognizance, the third relationship, is when all the alters know about each other but the host personality knows about none of them. The host will hear conversations in his/her head, these conversations are between the alters. This is when the alters know the host personality but is unable to affect it as long as the host is in control (Clark, 1993, p. 87-88). The cause of MPD is severe trauma, most of the trauma happens at a young age and the violator is usually someone who the child knows. In satanic cults, children mistreated and abused, to intentionally cause MPD, do not know everyone who is involved in the abuse. Examples given by Clark are children put in a coffin with rats, snakes, and bugs then buried alive. Later the satanic cult le ader or priest will rescue the child therefore making the child feel obligated to that person. In satanic cults, children are also raped. During the rape, men and women would violate the child they would also violate the child with objects such as a knife, an upside down crucifix, and other objects (Clark, 1993, 181-198). The child gets to the point where they think they are going to die, and they disassociate themselves from the situation, this is when the personalities are born. Other types of abuse are emotional and psychological abuse by a parent. One of Clarks patients remembered under hypnosis a time when she was two. Her mother took her outside put her in a tree and told her to jump, the child after a slight hesitation did so, and the mother stepped back, watched the child fall to the ground, and laughed. These traumatic events and others are the cause of MPD (Clark, 1993, 105-106). No matter how bad the abuse was and how many different personalities are present; a MPD patien t can be cured. The process to recovery for a MPD patient is long and hard. The personalities are not being made to disappear but to become one. There has to be a fusion of all the alters into the host, the host has to learn to express all the emotions, that for so long, another alter would take care of for them. Although some MPD patients are harder than others to fuse, but all patients can be cured. Patients that were subject to Satanic Ritual Abuse are more difficult to fuse due to the threats that the cult made or are making on their lives. A patient that was in a cult must have lost all contact with the cult before successful fusion can take place. When fusion is successfully accomplished, the host person can handle their emotions as where before fusion they were unaware of many common emotions (Clark, 1993, 208-213). Research is continuing to be done on this disorder. Many people still doubt the realism of the disorder, especially as more people fake the disorder to get out of judicial problems. About 1% of Americas population has MPD, but many are scared to see Psychiatrist, and many fake the disorder (Smith, 1993, p. 1). As awareness for the disease is becoming more prevalent, more patients are discovering after years of misdiagnosis, they finally can start the right kind of therapy. Multiple Personality Disorder is not a disease or mental illness, it is a disorder caused by traumatic events in early childhood. MPD is treatable and a MPD patient can hope to one day live a normal life with every part of his/her personality fused into one. A MPD patient is not something to be afraid of as where they usually just inflict pain upon themselves and not on others. MPD patients can be your next door neighbor, parent, and even spouse. They do not seem that different from normal people, and many do not even know they have the disorder. Awareness is the key, not only awareness of MPD but of child abuse, if child abuse is stopped MPD will not be a problem. Multipl e Personality Disorder is often brushed aside by Christians who think that MPD is demon possession, but MPD and demon possession differentiate in many ways. MPD although it can be caused by satanic ritual abuse is not evil, it is a process of the mind. Possession on the other hand, is when a body is taken over by an evil spirit. It is the physical body that the demon has control over not the mind. In MPD the only part affected is the mind, the body is not changed and does not convulse as it does in possession. In Ephesians 6:12(NIV) it is written, For our struggle is not against flesh and blood, but against rulers, against authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms. Demon possession is the fight against the flesh MPD is the fight against the mind. I do not believe that MPD is demon possession, I do believe that they are more susceptible to it if they have been involved in a satanic cult. MPD patients are gifted, smart individuals who suffered greatly as children and they used their only defense their imaginations to alleviate the pain. Our Hearts Grow Tender with Childhood Memories EssayIn conclusion I believe that anyone that believes they have MPD should seek help to bring out the feelings that are causing these split personalities to work against eachother and to join eachother and work together. EMDR is a new technic that is being tested and it causes you to bring out represt memories and to express and discuss the situations that you were put in. Psychology Essays

A History of African Slave Traders

A History of African Slave Traders During the era of the trans-Atlantic slave trade, Europeans did not have the power to invade African states or kidnap African slaves at will. For the most part, the 12.5 million slaves transported across the Atlantic Ocean were purchased from African slave traders. It is a piece of the triangle trade about which there are still many critical misperceptions. Motivations for Slavery One question that many Westerners have about African slavers, is why were they willing to sell their own people? Why would they sell Africans to Europeans? The simple answer to this question is that they did not see slaves as their own people. Blackness (as an identity or marker of difference) was a preoccupation of Europeans, not Africans. There was also in this era no sense of being African. (Indeed, to this day, individuals are more likely to identify as being African rather than, say, Kenyan only after leaving Africa.) Some slaves were prisoners of, and many of these may have been seen as enemies or rivals to those who sold them. Others were people who had fallen into debt. They were different by virtue of their status (what we might think of today as their class). Slavers also kidnapped people, but again, there was no reason they would inherently see slaves as their own. Slavery as a Part of Life It might be tempting to think that African slave traders did not know how bad European plantation slavery was, but there was a lot of movement across the Atlantic. Not all traders would have known about the horrors of the Middle Passage or what life awaited slaves, but others at least had an idea. There are always people willing to ruthlessly exploit others in the quest for money and power, but the story of the African slave trade goes much further than a few bad people. Slavery and the sale of slaves, though, were parts of life. The concept of not selling slaves to willing buyers would have seemed strange to many people up until the 1800s. The goal was not to protect slaves, but to ensure that oneself and ones kin were not reduced to slaves. A Self-Replicating Cycle As the slave trade intensified in the 16 and 1700s, it also became harder not to participate in the trade in some regions of West Africa. The enormous demand for African slaves led to the formation of a few states whose economy and politics were centered around slave raiding and trading. States and political factions that participated in the trade gained access to firearms and luxury goods, which could be used to secure political support. States and communities who were not actively participating in the slave trade were increasingly at a disadvantage. The Mossi Kingdom is an example of a state that resisted the slave trade until the 1800s when it began trading in slaves as well. Opposition to the Trans-Atlantic Slave Trade The Mossi Kingdom was not the only African state or community to resist selling slaves to Europeans. For instance, the king of the Kongo, Afonso I, who had converted to Catholicism, tried to stop the slave of slaves to Portuguese traders. He lacked the power, however, to police the whole of his territory, and traders as well as nobles engaged in the Trans-Atlantic slave trade to gain wealth and power. Alfonso tried writing to the Portuguese king and asking him to stop Portuguese traders from engaging in the slave trade, but his plea was ignored. The Benin Empire offers a very different example. Benin sold slaves to Europeans when it was expanding and fighting many wars - which produced prisoners of war. Once the state stabilized, it stopped trading slaves, until it started to decline in the 1700s. During this period of increasing instability, the state resumed participation in the slave trade.

Technical Description Definition essays

Technical Description Definition essays The word distributor can be defined into three different meanings. The first meaning, one that distributes, is the easiest to see since distribution comes from the word distribute. Distribution can also be defined as a wholesaler, or one that markets a commodity. The last definition of distribution is an apparatus in the ignition system that distributes the proper amount of electrical voltage to each spark plug at the correct sequence and time. The word is form the 15th century and it is pronounced di- stri-by Every automobile from todays era has a distributor. The distributor is the major component of the ignition system. The distributor is on either the side or the top of your engine, or up near the firewall (Crouse 304). The distributor looks somewhat like an octopus since it has wires that come out from the top of the cap. The distributor is designed to make and break the ignition primary circuit, a low-tension circuit, and to distribute the resultant high voltage to the proper cylinder at the correct time. The high voltage comes from the coil. The coil is a transformer outside of the distributor that changes low-voltage energy into high-voltage energy. After the high voltage comes out from the coil, it passes to the center terminal of the distributor cap and down the rotor by a wire attached to the coil that goes into the center tower of the distributor cap (Crouse 305-306). The purpose of the cap and rotor is to distribute the spark energy to the proper plug. The distributor cap covers the top part of the distributor. The cap has a tower for each spark plug cable, plus a center tower for the wire from the coil. The number of towers depends on the number of spark plug cables which is the same as how many cylinders the vehicle has. So a four-cylinder vehicl ...

Comparison of solar deities, specifically Ra, Surya, Apollo Essay

Comparison of solar deities, specifically Ra, Surya, Apollo - Essay Example stic religions and enjoyed much respect and honor and were depicted in the religious scriptures with their great deeds, relations with other deities and mortal people, myths and so on. However, they belong to different cultures: Apollo is a Greek god of Olympic period, Ra is a supreme solar deity of Old Kingdom period, and Surya is a Hindu deity referring to the sun (Gopal, 1990, p.76) and embodying the so-called â€Å"supreme light†. All three deities are male and very powerful, but Ra is granted more power as the creator. Ra is believed to have created himself and to be the supreme deity in ancient Egyptian religion, while Apollo was born from Zeus and Leto and Surya is the son of Dyaus Pita and Aditi (both are sons of the supreme gods of the pantheons, yet some sects consider Surya the Supreme Deity). Both Apollo and Surya have siblings: Apollo’s antipode and the lunar deity is his twin sister Artemis, and Surya is considered one of seven brothers Adityas, the cosmic deities. One more distinction of Ra is the form of his portrayal: Surya and Apollo are entirely anthropomorphic deities depicted both in sculpture and in iconography as humanlike beings; while Ra has many guises and can be depicted as a calf, child, lion or a man with the head of a falcon. The similarity to be highlighted between Apollo and Surya is their main attributes – both have chariots, yet Apollo’s one drawn by white swans and Surya’s chariot is horse-drawn (seven horses embodying sunrays or colors of rainbow). Ra, on the other hand, does not have such an attribute, having a sun disk, a scepter and uraeus, a serpent placed on his crown. Ra and Apollo’s worship cults are characterized by certain centers of worship and places of origin. For Ra, the place of origin and the principal center of worship is Heliopolis, while Delphi is the center of Apollo’s cult, where the temple with his oracles was located. The principal peculiarity of Surya in comparison to the other two deities

Research Methodology Paper Example | Topics and Well Written Essays - 2500 words

Methodology - Research Paper Example Secondary research and selection process Secondary research is the process of gathering pertinent information from the work of various scholars. The data collection technique accompanies additional methods to ensure accuracy in the development of the research findings. The technique gives researchers credible basis and guidelines to improve on. Secondary sources of data include electronic resources, books, journals and appropriate publications. The resources must carry relevant information to realize the research objectives. These are identifiable based on the researcher’s judgment that determines their reliability. In this study, the researcher has identified six journals to facilitate data collection. A systematic selection procedure sample (SSPS) that ensures the use of reliable resources was instrumental in the identification of the journals. Outline of six journal articles The journals are chosen as secondary data gathering techniques based on their relevance. They provid e appropriate information after a systematic study that led to the identification of the impact of tourism in fostering peace and growth. The journals enable the realization of valid and reliable results with the capacity to influence decision-making. Paulo (2002) who is a renowned writer explores the benefits of tourism in the society. The author focused on the benefits of tourism with an aim of relaying credible information to diverse stakeholders in the industry. This is with the intention of advancing the practice. He stated that tourism is significant in shaping the economic soundness of individuals and nations. Nations that focus on growth are responsible for adopting noble tourism practices to enhance monetary and social integration. The information also equips policy makers with the information highlighting the benefits of tourism. This enables them to formulate appropriate guidelines to drive operations in the sector. This is critical since the benefits of tourism are achie vable through the development of logical polices that are economically viable. Tourism presents fiscal, cultural, ecological, political and communal benefits. The benefits lead to the improvement of economic performance, rise in the living standards of the locals and cultural integration. These elements are fundamental in developing cohesive communities that are economically vibrant. In particular, tourism contributes to the creation of jobs to the citizens; furthermore, it improves income earnings, conservation of resources and restoration of cultural practices. It fosters understanding between individuals and community members through systematic engagement that leads to cohesiveness. The practice also contributes to cultural understanding, tolerance and protection of the national heritage. As noted by Paulo (2002) tourism enables the community members to enjoy the natural resources and facilitates understanding of the historical events that shape individuals future dealings. There fore, tourism presents immense benefits that nations should adopt. This would facilitate economic growth and social amalgamation. Bull (1999) focuses on the role of tourism in the economic development in the contemporary society. The author stated that tourism influences economic performance in various settings since it contributes to the GDP or the income per-capita. The income generated by the industry contributes significantly in transforming individual’

The Federal Government's Power through Application of the Commerce Research Paper

The Federal Government's Power through Application of the Commerce Clause - Research Paper Example The constitution however, does not provide an outright explanation for the term commerce. What then can be said to constitute commerce? Over the years commerce has been defined to mean the buying and selling of goods across states, this is known as interstate commerce and within states, which is known as intrastate commerce (Barnett, 2001). In Carter vs. Carter Coal Company1, the Supreme Court defined commerce as intercourse with the main reason of trade. Acts that fall within the concept of commerce are those acts that have a substantial effect to the exchange of goods within and across states. As seen under the commerce clause the federal government has the power to regulate commerce. What does it mean to regulate commerce? Regulating commerce according to Chief Justice Marshall regarding the case of Gibbons .v. Ogden2 means having the power to control the manner in which commerce is to be governed. Chief Justice Melville Fuller also gave a similar definition by stating regulation of commerce to mean the authority to prescribe the set of rules outlining the way the governing of commerce should take place. The federal government is formed out of a union between states and the sovereign power and this power is divided is therefore split between the national government and the various states (Bork & Troy, 2002). Discussion The original need for the commerce clause was mainly to discourage rivalry between those states that had a commercial advantage and those that did not have a commercial advantage. This difference in commercial advantage of states was brought due to the proximity to the harbor. Those states that were close to the harbor had a commercial advantage than those that were not. The commerce clause was initially meant to ensure that United States of America was a place where trade could take place freely without states having to bring up barriers against each other (Forte, 2011) therefore giving rise to rivalry. Originally, the term to regulate was in terpreted as making something regular. This clause was intended to make all the states regular by promoting activities that would encourage free trade across and within states and also to oversee any interference in interstate commerce. Federal power was intended to operate activities that fell within the scope of commerce but the courts kept quiet even when the federal government continued to see the general extension of the commerce clause. A good example is the case of Kidd vs. Pearson3 the court recognized the broad powers of the congress under the commerce clause over the sale of good in interstate commerce. The commerce clause was dormant over the years until the courts started making decisions that differentiated commerce and production (Bork & Troy, 2002) as seen in the case of Carter vs. Carter Coal Company4 the Supreme Court defined commerce as the intercourse with the main purpose of trade. The turning point of courts decisions came in with the landmark case of US vs. Lop ez5 the attempt of the federal government to regulate activities that are not commercial was struck down in a ruling. The court stated that the power of the congress under the commerce clause is limited to only commerce and the power to regulate the carrying of guns was not commercial

Sudden Sensorineural Hearing Loss (SSNHL) Intervention

Sudden Sensorineural Hearing Loss (SSNHL) Intervention Henry Davis Hearing loss is not a common healthcare issue addressed by Nurse Practitioners (NP) and Sudden Sensorineural Hearing Loss (SSNHL) occurs even less frequently. Often the onset of hearing loss (related to aging or noise exposure) is insidious, often spanning months to years and is typically bilateral. Hearing loss that occurs with advanced age is routinely compensated for with the use of electronic devices that amplify sound and this type of hearing loss is typically not cured. SSNHL by contrast has a well-defined acute onset within 3 days and is characteristically unilateral hearing loss. Some cases of SSNHL could be cured if a diagnosis is made and treatment initiated within a short time from onset of the hearing loss (Raghunandhan et al., 2012). Nurse practitioners may often be the first healthcare provider the patient encounters. Because of the early patient contact, nurse practitioners are uniquely poised to initiate the first line treatment after consulting with neurology, but prior to referral for follow-up care and further evaluation. Recent research supports that patients who receive early medical treatment for SSNHL recover hearing more often than those, who received delayed care (Raghunandhan et al., 2012). Epidemiology Current research indicates the morbidity of SSNHL is 2-20/ 100,000 persons annually and the mean age of occurrence is 43-53 years old. Mortality as not reported other than a possible link between SSNHL and strokes. Gender does not appear to influence incidents. Risk factors for SSNHL include; advanced age, concurrent cardiovascular disease and the presence of a positive antinuclear antibody (Weber, 2014). One study indicated â€Å"†¦viral infection being the most common etiological factor† for SSNHL (Raghunandhan et al., 2012, p. 229). Etiology The cause of SSNHL is currently considered idiopathic, however the preponderance of current research is directed at the supposition that the etiology of SSNHL is due to edema of the eighth cranial and subsequent compression of the internal auditory artery to the cochlea and circular apparatus. The likely cause of the compression is edema of the auditory nerve within the confined space of the internal auditory meatus from a viral infection (Mom, Chazal, Gabrillargues, Gilain, Avan, 2005). There is minimal clearance for the nerves and vessels. If any edema occurs, compression of the associated structures can result. This would be similar in nature to the pathology associated with Bell’s palsy or compartment syndrome associated with a casted extremity. The surrounding tissue swells and compresses adjacent structures. Cause of SSNHL is currently identified as idiopathic but current treatment targets a viral infection as the causative agent. Early treatment with steroids and antiviral drugs demonstrated reduction in percentage of patients who experience total hearing loss. The nurse practitioner can begin treatment of the patient and ensure timely neurologic specialty follow-up and magnetic resonance imaging (MRI) to rule out acoustic neuroma (Chen, Halpin, Rauch, 2003). Pathogenesis Initially to understand SSNHL we first should examine the anatomy and function of the inner ear. The ear communicates with the brain via eighth cranial nerve. The eighth cranial nerve divides into two main branches, cochlear and vestibular nerves. The first cochlear nerve travels to the cochlea and the vestibular nerve travels to the semicircular ducts. The Cochlea is the portion of the inner ear responsible for the transformation of sound from a physical force, from the tympanic membrane via the malleus, incus and stapes into a nerve impulse conducted to the brain via the cranial nerve (Copstead Banasik, 2013). The vestibular nerve conducts impulses from the semicircular ducts. Semicircular ducts change the forces of air movement into fluid movement that in turn is changed into nerve impulses that allow for proprioception. Damage to this branch of the vestibular nerve can result in vertigo, nystagmus, vomiting and disruptions of proprioception (Copstead Banasik, 2013). The eighth cranial nerve passes through a relatively small opening, the internal auditory meatus, in the skull(Weber, 2014) (Kim Lee, 2009). This small opening also provides the arterial blood flow for the inner ear via the internal auditory artery (Kim Lee, 2009). Even a small amount of edema in the eighth cranial nerve can result in both compression of the nerve and occlusion of the arterial blood supply to the inner ear. The result of these Sequelae would be rapid hearing loss, nystagmus and vertigo (Weber, 2014). During the acute period, the first few hours, it would be possible to decrease the edema by administration of steroids thereby decompressing the nerve and re-establishing blood flow to the inner ear (Narozny et al., 2006). Delays in the reduction of this edema may result in tissue necrosis and clot formation due to stasis of blood in the internal auditory artery. Another less researched cause of SSNHL is vertebrobasilar ischemic stroke or a thrombi occlusion of the arterial supply to the inner ear (Kim Lee, 2009). The resultant Sequelae following the occlusion would mirror the presentation of SSNHL from edema however; the key difference would be the response to oral steroids is ineffective. Any negative effects of oral steroids, if an ischemic stroke were diagnosed would be minimal as the follow-up for MRI should be performed immediately after initial treatment. Clinical Manifestations Onset of SSNHL appears as idiopathic and not related to any trauma and patient denies current source of infection. The patient may report having a clogged ear or pressure in ear. There is an absence of signs and symptoms of infection such as fever, drainage and pain. The patient may find it difficult to impossible to determine the direction of the source of a sound, as both ears are needed to identify the direction of a source of a sound. The brain normally uses the auditory input from both ears identify source location of an auditory stimulus. The occlusion of blood flow to the cochlea on one side has resulted in complete hearing loss to that side. SSNHL may present with an acute onset of tinnitus in the affected ear. The patient may describe the sound as a ringing or roaring sound. Initial onset of tinnitus may cause difficulty in concentration. The pathology responsible for tinnitus remains unclear. The onset of SSNHL is rapid and unilateral, proceeding from normal hearing to complete absence of hearing of the effected ear in less than 3 hours(Weber, 2014). SSNHL is often accompanied by nystagmus, tinnitus and vertigo. This may be due to the compression of the internal auditory artery and the resultant occlusion of blood flow to the cochlea and semicircular apparatus. In addition, when we consider the functions of the central nervous system in the perception of proprioception, multiple stimuli typically confirm the position of the body such as the semicircular apparatus and visual stimuli. With the sudden cessation of blood flow to the inner ear, a mismatch of stimuli rapidly occurs. This mismatch of stimuli among various nerves results in the perception of vertigo and often nystagmus. The Performance of a Rinne test and Weber test enables the nurse practitioner to differentiate between bone conduction damage, as is the case with traumatic injury or nerve damage as is the case in both SSNHL and ischemic stroke (Tintinalli, 2010). Also important is the Dix-Hallpike test, to differentiate between central or peripheral vertigo (Furman Barton, 2014). Central vertigo would be those with a site of origin inside the brain, were as peripheral vertigo originates outside the brain. The Dix-Hallpike test differentiates between central and peripheral vertigo. A Dix-Hallpike test is positive if vertigo and nystagmus is elicited when the head is rotated. Dix-Hallpike test also identifies unilateral vertigo, as well as it differentiates between central and peripheral causes of vertigo and nystagmus. Benign positional nystagmus is also evaluated utilizing the Dix-Hallpike test. In (BPN) the result is a delay of onset of nystagmus of >20seconds, nystagmus slowly resolves if head h eld in the same position, and response decreases with repeated testing (Dix-Hallpike Test, 2014). A central cause of vertigo and nystagmus need to be evaluated if the Dix-Hallpike test yields atypical results of nystagmus that occurs without rotation of the head, begins without delay, and does not decrease with retesting(Dix-Hallpike Test, 2014). Treatment The recommended treatment of SSNHL is early administration of oral glucocorticoids (Raghunandhan et al., 2012)(Narozny et al., 2006). This intervention is well within the scope of practice of the Nurse Practitioner. Nurse Practitioners should be encouraged to take the lead in diagnosing and initiating treatment for SSNHL. The risk associated with early treatment of suspected SSNHL is minimal however if treatment is delayed hearing loss may be permanent. The indication for administration of steroids is to decrease edema of the eighth cranial nerve as this edema leads to loss of nerve conduction and ultimately nerve tissue death and possible arterial occlusion (Chen et al., 2003). The result of tissue death of the eighth cranial nerve is hearing loss, nystagmus, tinnitus and impaired balance (Copstead Banasik, 2013). Current treatment of SSNHL aims at the reduction of damage to the eighth cranial nerve. Other medications can be used to treat the after effects of SSNHL such as vertigo. Select antihistamines, which are also classified as vestibular suppressant, are often used to decrease the perception of vertigo. These drugs reduce â€Å"the activity in the vestibular nuclei and cerebellum.†(Denner, 2013, para. 6). This class of medication is used as needed for vertigo control. Vestibular suppressant antihistamines are first line medications for vertigo. If Vestibular suppressant antihistamines are not successful in controlling vertigo then an escalation to a low dose benzodiazepine most often resolves vertigo not controlled by first line medications. Benzodiazepines cause central nervous system depression and thereby decrease vertigo. The treatment of choice for chronic vertigo is vestibular rehabilitation. Vestibular Rehabilitation is an exercise-based therapy used to retrain the central nervous system (CNS). Often vestibular rehabilitation is sufficient to control symptoms of vertigo without the need for daily medications. The provider often refers the patient experiencing vertigo to physical therapy (PT) or occupational therapy (OT) for a course of progressive exercises with associated head/eye movements to retraining the CNS (Vestibular Rehabilitation Therapy (VRT), 2014). Vestibular rehabilitation can greatly reduce the need for medications to reduce symptoms of vertigo and improves the quality of life. Vestibular rehabilitation is only the first of many topics that should be addressed by the nurse practitioner to assist the patient in lessening symptoms and coping with functional loss. Patient education is targeted toward identification of limitation and practices to compensate for those limitations. Simple functions such as body position during sleep can cause functional problems for patients. An example would be if patient sleeps on the non-affected ear toward the pillow, they would not hear sounds such as alarm clocks, smoke alarms, or other auditory products. Specialized alarms are available which provide both auditory and tactile stimuli (a strong bed vibrating unit) to awaken non-hearing or limited hearing persons. Also, educate patient that stressful situations and loud environments can exacerbate the experience of tinnitus and vertigo. Family members of the patient would be educated on actions to compensate for patient’s hearing loss. Walking on the non-affected side and not speaking close to affected ear are two examples. Also explaining the emotional stressors for the patient and the family members as both learn to cope with the new limitations. The Nurse Practitioner can also provide a referral to an ear, nose and throat specialist to evaluate the patient for cochlear implant for complete unilateral hearing loss. Current implants consist of a base magnet implant into the mastoid bone on the affected side. An external device is worn over the magnet and conducts sound into the magnet and across to the functional ear via bone conduction. The delay between air and bone conduction allows the patient to regain the ability to directionalize sound stimuli. The negative impacts of this option are cost, some insurances do not cover this surgery or only cover a portion of the total cost and this is a surgical intervention and all invasive procedure have associated risk factors. Conclusion Nurse Practitioners should broaden the scope of examination and treatment when assessing patients with sudden hearing loss. In the face of a presumptive diagnosis of SSNHL, the provider may improve outcomes by beginning treatment prior to conclusive diagnosis. Increased early intervention for SSNHL by Nurse Practitioners and beginning steroid treatment within the first few hours after onset of hearing loss may decrease the incidence of permanent hearing loss. The Nurse Practitioner is able to discriminate between sensorineural and conductive hearing loss. A causative factor is then diagnosed to direct care. SSNHL is an infrequently occurring health problem that can be treated with an early presumptive diagnosis. If the initial diagnosis of SSNHL is delayed for MRI to rule out Acoustic Neuroma, it increases the chance that hearing loss will become irreversible. The initial treatment with oral steroid is relatively low risk, yet this option is often omitted despite the apparent benefit. Although the confirmation of SNNHL requires MRI to rule out a differential diagnosis of acoustic neuroma, steroid treatment could begin as a protective measure. If an Acoustic Neuroma is diagnosed the steroid therapy could be discontinued. The impact of steroid use associated with Acoustic Neuroma has not been examined in current research. Appendix Figure 1 (Arora, 2012, figure 5) Figure 2 (Kim Lee, 2009, figure 2) References Arora, R. (2012). Vestibular Rehabilitation: An Overview. Int J Otorhinolaryngol Clin, 4, 54-69. Retrieved from http://www.jaypeejournals.com/eJournals/ShowText.aspx?ID=3564Type=FREETYP=TOPIN=_eJournals/images/JPLOGO.gifIID=280isPDF=NO Chen, C., Halpin, C., Rauch, S. (2003). Oral Steroid Treatment of Sudden Sensorineural Hearing Loss: A Ten Year Retrospective Analysis. Otology Neurotology, 24, 728–733. Retrieved from http://www.researchgate.net/publication/9088236_Oral_steroid_treatment_of_sudden_sensorineural_hearing_loss_a_ten_year_retrospective_analysis/links/00b7d51c062542efbc000000 Copstead, L., Banasik, J. (2013). Pathophysiogology (5th ed.). St. Louis, MO: Elsevier. Denner, K. (2013). Meclizine – Does it help? Retrieved from http://vestibular.org/news/10-07-2013/meclizine-–-does-it-help Dix-Hallpike test – Quick guide. (2014). Retrieved from http://www.ncuh.nhs.uk/our-services/dix-hallpike-test-quick-guide.pdf FM Jr, B. (1984). Sudden hearing loss: eight years experience and suggested prognostic table. The Laryngoscope, 94, 647-61. Retrieved from http://ezproxy.okcu.edu:2192/ehost/detail/detail?vid=1[emailprotected]hid=4201bdata=JnNpdGU9ZWhvc3QtbGl2ZQ==#db=mnhAN=6325838 Furman, J., Barton, J. (2014). Evaluation of the patient with vertigo. Retrieved from http://www.uptodate.com/contents/evaluation-of-the-patient-with-vertigo?source=machineLearningsearch=Dix-HallpikeselectedTitle=2~5sectionRank=5anchor=H29#H29 Hearing Loss: A Ten Year Retrospective Analysis. Otology Neurotology, 24, 728-733. Retrieved from http://www.tonybaino.com/otorhino/steroidsssnhl.pdf Kim, J., Lee, H. (2009). Inner Ear Dysfunction Due to Vertebrobasilar Ischemic Stroke. SEMINARS IN NEUROLOGY, 29, 534-540. http://dx.doi.org/10.1055/s-0029-1241037 Mom, T., Chazal, J., Gabrillargues, J., Gilain, L., Avan, P. (2005). Cochlear blood supply: an update on anatomy and function. French Ear, Nose Laryngology, 88, 81-88. Retrieved from http://xa.yimg.com/kq/groups/17470070/1437766444/name/KimJS2009 [Inner Ear Dysfunction Due VB Ischemic Stroke].pdf Our Experience. Association of Otolaryngologists of India, 65, 229-233. http://dx.doi.org/10.1007/s12070-012-0506-9 Our Experience and a Review of the Literature. Annals of Otology. 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Alcohol And The Church :: essays research papers

Alcohol And The Church It seems to be that our main questions are, Should we use alcohol and what about those that abuse it? How should the Church deal with those that do drink or should we as a society deal with it? While there is nothing in the Bible that says drinking is a sin, but drunkeness is. I believe as a society we do have a problem with alcohol abuse. But in the same respect I do not feel that the church should judge those who do drink socially, regularly, or abusively. When the time comes everyone will be judged individually by God alone. I feel it is his decision solely to do what is best for all. The church may teach not to use alcohol, but to discriminate against those in the congregation (or even those that are not) that do is not a solution to the problem. I feel in order to get alcohol abuse under control we as a society need to teach our children the risks of using alcohol, not only in the home but in the schools as well. To reach the heart of the problem is to face the problem head on. As a social drinker myself (I put my self in this classification) I don't feel I have an alcohol problem just because I enjoy a drink now and then. I do not abuse it and would never put myself behind the wheel of a car to take the risk of taking someone else's life. You don't need to be drunk to cause an accident, it's been proven in many cases only a few drinks can impair someone's stability. If more thought of this there would be less tragedies on our highways. When it comes to food and there are people starving in the world, when we could help by not converting food grains into alcohol, this should be made more aware to our society. I'm not sure most people are aware of this. It is supposedly our main concern to feed the hungry and shelter the poor. If giving up something that only contributes to loneliness and destruction than ever, because there are more that abuse than those who don't, it seems to me to be a logical solution. I think the best we can hope for in our future and our children's is that we have to