Using Epanorthosis in Rhetoric

Utilizing Epanorthosis in Rhetoric An interesting expression wherein a speaker revises or remarks on something the individual has quite recently said. A withdrawal (or pseudo-withdrawal) is a sort of epanorthosis. Modifier: epanorthotic.Epanorthosis is otherwise called correctio or self-remedy. The historical underpinnings is from the Greek, sorting out once more. Models and Observations Perhaps there is a brute. . . . What I mean is . . . perhaps its solitary us. (Simon in Lord of the Flies by William Golding, 1954)​With a hurl of his chest, Croker rose and came walkingor, rather, limpingtoward him. (Tom Wolfe, A Man in Full, 1998)​[A] great heart, Kate, is the sun and the moon; or, rather, the sun, and not the moon; for it sparkles splendid and never shows signs of change, yet keeps his course really. (Ruler Henry V in Act V, scene two of Henry V by William Shakespeare, 1600)​I dont like most of what I do. I shouldnt state I dont like it, however Im not happy with nearly everything that I do. (Paul Simon)​You dont believe were being . . . I dont need to state shabby, on the grounds that that is not the correct word, however somewhat reckless, perhaps? (Owen Wilson as John Beckwith, The Wedding Crashers, 2005)​Epanorthosis, or Correction, is a figure by which we withdraw or review what we have spoken, for subbing something more gro unded or progressively appropriate in its place... The utilization of this figure lies in the startling interference it provides for the current of our talk, by turning the stream in a manner of speaking back upon itself, and afterward returning it upon the inspector with intensified power and accuracy. The idea of this figure directs its articulation; it is to some degree much the same as the enclosure. What we right ought to be so articulated as to appear the quick radiation existing apart from everything else; for which reason it doesn't just require a partition from the remainder of the sentence, by a modification of the voice into an ease off volume, however a sudden discontinuance of the part promptly going before. (John Walker, A Rhetorical Grammar, 1822)​ He has recently been grinding away telling once more, as they call it, a most needless bit of insidiousness, and has caused a coolness in between me and (not a companion precisely, yet) a close colleague. (Charles Lamb, letter to Samuel Taylor Coleridge, Jan. 10, 1820)​Thence have I followed it(Or it hath drawn me, rather) yet tis gone. (Ferdinand in The Tempest by William Shakespeare)​In epanorthosis, or fixing, one reconsiders what one has said and qualifies it or even takes it back, as in Augustines exemplary Give me virtuousness and continencebut not yet (Confessions 8.7). Epanorthosis is especially uncovering of the character of the speaker, for this situation, of a conniving soul separated against itself and offered more to self-misdirection than to double dealing of others. (P. Christopher Smith, The Hermeneutics of Original Argument: Demonstration, Dialectic, Rhetoric. Northwestern Univ. Press, 1998)​They reserve a privilege to more solace than they at pr esent appreciate; and more solace may be managed them, without infringing on the delights of the rich: not currently holding on to enquire whether the rich reserve any option to restrictive joys. What do I say?encroaching! No; if an intercourse were built up between them, it would confer the main genuine delight that can be grabbed in this place that is known for shadows, this hard school of good order. (Mary Wollstonecraft, A Vindication of the Rights of Men, 1790)​ I ought to presumably have said at the beginning Im noted for having something of a comical inclination, despite the fact that I have remained quiet about myself particularly in the course of the most recent two years in any case, figuratively speaking, and its just as relatively as of late that I started to realizewell, er, maybe acknowledge isn't the right word, er, envision, envision that I was not by any means the only thing in her life. (Michael Palin in scene two of Monty Pythons Flying Circus, 1969)

10 Jobs That Will Hire You Today, Even With No Experience

10 Jobs That Will Hire You Today, Even With No Experience Recently out of school? Searching for your first occupation? Searching for a new position following quite a while of not being in the activity power? Need to get a new position in another field brisk? You may wind up slamming your head against the Catch 22 of requiring involvement with request to find a new line of work and afterward get said understanding. You may imagine that there are no average paying employments worth taking that don’t require at least understanding. Be that as it may, you’d not be right. Here are various superbly steady employments that don’t expect you to have work involvement with that field. Remain in them cheerfully, or use them as a venturing stone to other vocation moves.1. Regulatory AssistantWhat is esteemed most by individuals hoping to employ an administrator associate or an official secretary isn't understanding, yet expertise. Would you be able to carry out the responsibility. It is safe to say that you are supernaturally sorted out? Excessively solid, dependable, careful, ready to perform multiple tasks as well as anyone? Ready to get cleaning and handle private lawful and monetary data? Acquainted with word-preparing, database, and spreadsheet programming? Would you be able to type? You’re recruited. Normal compensation: almost $38k per year.2. Conveyance DriverHave a clean driver’s permit? Get work for a national, nearby, worldwide, or provincial organization driving conveyance vehicles. You’ll even have the advantage of a lot of booking adaptability and an opportunity to get your foot in the entryway at an organization. Normal pay: somewhere in the range of $16-46k per year.3. Bill CollectorDidn’t even know this was an occupation? All you need is a secondary school certificate, great telephone way, and great client care aptitudes to have the option to help pursue initial installments from careless payers. This profession is relied upon to become 19% in the following ten year s and the normal compensation ranges from $21-48k per year.4. Security OfficerAlways needed to be a cop yet don’t need to waste time with all the preparation? Take a stab at being a security official for a place of business, an anteroom, an exhibition hall, or a shopping center. You’ll must be on your feet more often than not, yet you’ll land on-the-position preparing, adaptable hours, and the normal pay is over $35k per year.5. BartenderIf you can deal with the work, and make the beverages, and shield from overserving rowdy customer base, at that point you can bring in incredible cash behind a bar. On the off chance that experience is fundamental for one of these employments, it is as a rule as basic as going to a course or bartending school. What's more, you can make as much as $50k per year.6. School Bus DriverYou’ll must be understanding and an incredibly, safe driver, yet you can make somewhere in the range of $16-$40k driving youngsters to and from school-with no related knowledge. You may even score some not too bad benefits.7. Land BrokerYou need to take a 60-hour course and breeze through an assessment, however once you do, you’re qualified to be a merchant. What makes a difference in this activity is more who you know and how wide your system, instead of how long you’ve been selling houses. On the off chance that you’re great at deals and amiable, this may be for you. It begins little, yet the pay can be fiercely luring. Normal compensation ranges from: $30-227k.8. HR AssistantHelp screen work candidates for organizations (and pick up something all the while). You’ll get tolerable advantages and a serious compensation (around $38k every year). Also, the more aptitudes you have with PCs and correspondence, the happier you’ll be.9. ClerkConsider working at the neighborhood town hall, DMV, or city office. Regional authorities utilize a huge amount of individuals; you should be one of them! E xperience prerequisites are low, however benefits are high. What's more, the normal compensation is around $38k.10. Link InstallerEver wonder about the person or lady who comes to introduce your link or web? Odds are you could have their activity with practically zero understanding. You’ll land on-the position preparing, obviously. Furthermore, relationship building abilities are an or more. Contact your nearby supplier to see about employment opportunities. Normal yearly pay: between $21-52k.

The Link Between Tic Disorders and ADHD

The Link Between Tic Disorders and ADHD ADHD Symptoms Print The Link Between Tic Disorders and ADHD By Keath Low Keath Low, MA, is a therapist and clinical scientist with the Carolina Institute for Developmental Disabilities at the University of North Carolina. She specializes in treatment of ADD/ADHD. Learn about our editorial policy Keath Low Updated on February 18, 2020 ADHD Overview Symptoms Causes Diagnosis Treatment Living With In Children Carol Yepes / Getty Images Tics are characterized by repeated, sudden, jerky, involuntary movements of one’s face, shoulders, hands, legs or other body parts. Movements may include eye blinking, shoulder shrugging, neck twisting, facial grimacing, sticking out tongue, flaring nostrils, clenching fists, jerking arms, kicking, and curling toes. Tics can also be vocal. These vocal tics may include throat-clearing, sniffing or snorting, grunting, dry coughs, clicking, hissing, barking, or even words or phrases. These movements and/or vocalizations may occur frequently throughout the day or they may occur only occasionally. They tend to increase under excitement, physical or social stress, anxiety  if the individual is very tired, or very idle. Some medications are also believed to exacerbate tics.?? Tics occur less often when a person is relaxed and calm. Tics do not occur during sleep. Treatment Treatment for an individual with a tic disorder may include medication to help control the symptoms. The older typical neuroleptics such as pimozide and Haldol are often used to reduce tics, in addition to the newer atypical neuroleptics/antipsychotics such as risperidone. Clonidine and guanfacine, types of anti-hypertensive agents, may also be used because of their reduced side effects.?? How Common Are Tic Disorders? The most common tic disorder is called provisional tic disorder (PTD), which was previously known as transient tic disorder, which is common in children.?? Tics which last one year or more are called persistent tics, which are also known as chronic motor of vocal tic disorders (CMVTD). Tics occur in about 20% of school-age children. Approximately 1 in 5 children age 6-17 years old may develop a tic, but may sometimes start as early as 2 years of age.?? Tic disorders do appear to have a genetic link, as they tend to run in families, and have also been linked to environmental factors. Chronic tic disorders affect about one percent of children and may indicate a more serious disorder called Tourette Syndrome (TS).?? Tourette Syndrome Tourette syndrome is a genetic, neurological disorder whose primary manifestations are the presence of motor and vocal tics. Tourettes is commonly associated with ADHD, obsessive-compulsive disorder, behavior problems, and learning disabilities. The National Institute of Neurological Disorders and Stroke report that approximately 200,000 Americans have the most severe form of Tourettes, while as many as one in 100 display the milder symptoms such as a chronic motor or vocal tics or provisional tics of childhood.?? Though Tourettes is a lifelong condition, symptoms tend to peak during the early teenage years with improvement in later adolescence and adulthood. Tourettes affects males approximately three to four times more often than females.?? ADHD A 2016 study found that 35â€"90% of children with tics also had ADHD.?? Research has found that chronic tic disorders, Tourette syndrome, and obsessive-compulsive disorder may have similar neurological origins, and an individual with any of these conditions is also quite likely to have ADHD. In children who develop tic disorders and ADHD, the ADHD usually develops 2 to 3 years before the tics.?? There has been some controversy over whether stimulants, the most common form of medication therapy for ADHD, worsen or even causes tics. Studies indicate that most children with co-occurring tics and ADHD do not experience an increase in tic severity while on low to moderate doses of stimulants.?? However, there does appear to be a small proportion of children for whom this is a problem. It is not clear if the stimulants actually cause the tic or if the stimulants trigger tics that were already pre-existing, but not yet obvious.?? It is also possible that tic disorders may look similar to ADHD in their early stages. So the tic would have developed whether or not the child had been treated with stimulants. If your ADHD child develops tics, report it to your child’s doctor. Together you will weigh the risks and potential benefits of medication, as well as explore alternative medicines to stimulants.

Functions of Religion in Society Essay - 1381 Words

In its simplest form any religion may be seen as a belief system. This system may affect values, laws, customs, rites and general behaviour patterns. Religion may affect the individual, group, community or nation. It may play a peripheral or an integral role within society. Its structure may be as complex as any large organisational bureaucracy or as simple as a two-way relationship between a person and object/subject of worship. The function of religion in a society is often to explain to the people in that society their primal origins, the nature of life, the function and aims of life and reasons for living. To put it simply, to answer the question why am I here? In the past religion has been used as a control mechanism, a way of†¦show more content†¦The beliefs and values a society holds are often incorporated into the religion. Collectively they may constitute the morality of a society. The laws and rules governing a society can reflect this morality. Control and systems of punishment can be woven into the fabric of religion and in some societies are a dominant feature. Punishment may be immediate and harsh acquiring legitimacy through the years or it may be postponed until after death when the severity is magnified by mysticism and imagination. The alternative to punishment may be to control through forgiveness and penance, mercy is a fine quality and most societies recognise its value and influence. Religion may be seen as one social process among many social processes. It is the product of human minds, a complex social entity that has been passed down through generations. As a product of society it is inextricably bound up with other social products such as politics, economics, law, music and art. It has however an energy of its own, once born it can develop and change of its own accord; it can generate its own rules. In general it is meaningful only to those who belong to the culture from which the religion emerged. Religion can be transferred from one culture to another, but usually with difficulty and with questionable success. Religions can be as varied as the many different cultures from which they emerge. The major world religions may be listed as follows :- •Show MoreRelated Functionalist View on the Role and Functions of Religion in Society716 Words   |  3 PagesFunctionalist View on the Role and Functions of Religion in Society Assess the view that sociological arguments and evidence support the Functionalist view of the role and functions of religion in contemporary society. Functionalists believe that religion is a conservative force, and an institution which adds to the requirements of society. They say it ultimately operates as an agency of socialisation. Durkheim (1912) said that all societies are separated into the profane Read MoreEvaluate Feminist Views on the Role and Functions of Religion in Society Today.724 Words   |  3 Pagesviews on the role and functions of religion in society today. Feminists see religion as an instrument of patriarchy which means that society is based around male domination; they believe that this is a set of beliefs and practices responsible for women’s subordination. However functionalists believe otherwise and argue that its function is not to oppress women but to keep society stable whilst Marxists believe that religion oppresses the working class not females. Most religions argue that thereRead MoreEvaluate Postmodernist Explanations of the Role and Functions of Religion in Contemporary Society.1606 Words   |  7 Pagesof the role and functions of religion in contemporary society. Postmodernist religion can be defined as any type of religion that is influenced, interpreted or shaped by postmodernism and postmodern philosophies. Postmodern religion is not an attempt to banish religion from society; rather, it is a philosophical approach to religion that considers orthodox assumptions that may reflect power differences in society rather than universal truths. A postmodern interpretation of religion emphasises theRead MoreMarx And Durkheim On Religion839 Words   |  4 PagesMarx and Durkheim on Religion SOC201 998036931 Kirsten Kelleher Both Karl Marx and Emile Durkheim formulate similar sociological theories regarding the epistemology and origin of religion and religious beliefs. Both thinkers acknowledge a necessary connection between community and religion. As antagonistic, functionalist thinkers, both Marx and Durkheim maintain that â€Å"God† or the â€Å"divine†, is merely a projection of human beings highest ideals and greatest characteristics creating a â€Å"God† like illusionRead MoreThe Main Function of Religion According to Sociological Arguments685 Words   |  3 PagesThe Main Function of Religion According to Sociological Arguments Many sociologists believe that the main function of religion is to provide people with a code of conduct, which regulates personal and social life. There are two main theories to what role religion plays within society. One of these theories is the Marxist theory. Marxism sees society as superstructure. They believe that society isn’t peaceful and is based on conflict and exploitation. Religion makes thisRead MoreFunctionalist approach to religion1623 Words   |  7 Pagesï » ¿Discuss the functionalist perspective on religion. (20 marks) The functionalist perspective is a consensus theory; it believes that society has a set of shared values and beliefs. Durkheim was the 1st functionalist to develop the idea that religious institutions play a central part in creating and maintaining value consensus, order and solidarity. The anthropologist, Malinowski, built on Durkheims idea and expanded with his own ideas. The functionalists, Parsons and Bellah later added theirRead MoreSociological Perspectives Of Functionalism, Conflict Theory And Symbolic Interactions882 Words   |  4 Pagesinteractions. In looking at how religion functions in social structures, social systems, and small group interpersonal interactions a sociologist could formulate a better understanding of religion s role in society and the human experience. The sociologist looks at the individual, and how that individual connects to a specific societal location or setting and specifically at religion a sociological study could determine the power religion holds over people and societies. Understanding the culturalRead MoreAssess the usefulness of functionalist theories in understanding religion today920 Words   |  4 Pagesusefulness of functionalist theories in understanding religion today (33 marks) Functionalists have put forward their perspective on religion and how it benefits both society and the individual starting with how religion brings people together harmoniously, creating social cohesion and a sense of belonging as people believe in the same thing and all abide by the same rules. Religion creates and maintains a value consensus whilst giving society social order. By conforming to religious beliefs thisRead MoreSociological Perspectives Of Structural Functionalism1490 Words   |  6 Pagespaper –religion (as a primarily social rather than theological or psychological phenomenon) and the effects on societies. In looking at how religion functions in social structures, social systems, and small group interpersonal interactions sociologists could formulate a better understanding of religion s role in society and the human experience. The sociologist looks at the individual agency, and how that connects to a specific societal location or setting. Specifically, in th e case of religion a sociologistRead MoreEmile Durkheim Was A French Sociologist And Philosopher.1003 Words   |  5 PagesOne of his most prominent interests as a scholar was religion. In particular, the manner in which religion has developed throughout the history of the human race. While Durkheim wrote a good deal on religion, perhaps his most important work on religion was written in The Elementary Forms of Religious Life. In this work, Durkheim examines Australian Totem religious as fundamental forms of the human religious experience. His ideas regarding religion are largely based off of his studies of Australian

Virgil Quotations With English Translations

Publius Vergilius Maro (October 15, 70 BCE - September 21, 19 BCE) was the leading poet of the Augustan era. His Aeneid glorified Rome and especially the ancestry of the first Roman emperor, Augustus (Octavian). The influence of Virgil (Vergil) on subsequent writers has been immense. He is responsible for sayings or the sentiments behind sayings that we still use, like Beware of Greeks bearing gifts, from Book II of the Aeneid. All Virgil quotations listed here include a reference to their original location, the Latin that Virgil wrote, and either an old, almost archaic translation from the public domain (mainly for the longer passages) or my own translation. [Lat., Experto credite.]Believe in the one who knows from experience. (Trust the expert.)- The Aeneid (XI.283)[Lat., Non ignara mali, miseris succurrere disco]Not being ignorant of bad things, I learn to help the wretched.- The Aeneid (I.630)[Lat., Superanda omnis fortuna ferendo est.]Every fortune is to be conquered by bearing (it).- The Aeneid (V. 710)[Lat., Quisque suos patimur manes.]We each allow our own ghosts. (We make our own destiny.)- The Aeneid (VI.743)[Lat., Disce, puer, virtutem ex me, verumque laborem; Fortunam ex aliis.]Boy, learn virtue from me, and true work; luck from others.- The Aeneid (XII, 435)[Lat., Saevit amor ferri et scelerata insania belli.]Love of iron (weapon) rages; also the criminal madness of war.- The Aeneid (VII.461)[Lat., Nescia mens hominum fati sortisque futurae,Et servare modum, rebus sublata secundis.]O heart of man,/ not knowing doom, nor of events to be!/ Nor, being lifted up, to keep thy bounds/ in prosperous days!- The Aeneid (X.501)[Lat., S tat sua cuique dies; breve et irreparabile tempusOmnibus est vitae; set famam extendere factisHoc virtutis opus.]To each his day is given. Beyond recall/ mans little time runs by: but to prolong/ lifes glory by great deeds is virtues power.- The Aeneid (X.467)[Lat., Aegrescitque medendo.]He grows increasingly ill with the remedy. (The medicine is making him sick.)- The Aeneid (XII.46)[Lat., O formose puer, nimium ne crede colori;]Oh! Beautiful boy, dont put too much faith on (your) complexion. (Perhaps, beauty fades.)- Eclogae (II.17) *The real version, Nunc scio, quid sit Amor, comes from Virgils Eclogues VIII.43. Not all misquotes are so easy to untangle.

The Life of Andrew Carnegie Free Essays

A man of Scotland, a distinguished citizen of the United States, and a philanthropist devoted to the betterment of the world around him, Andrew Carnegie became famous at the turn of the twentieth century and became a real life rags to riches story. Born in Dunfermline, Scotland, on November 25, 1835, Andrew Carnegie entered the world in poverty. The son of a hand weaver, Carnegie received his only formal education during the short time between his birth and his move to the United States. We will write a custom essay sample on The Life of Andrew Carnegie or any similar topic only for you Order Now When steam machinery for weaving came into use, Carnegie†s father sold his looms and household goods, sailing to America with his wife and two sons. At this time, Andrew was twelve, and his brother, Thomas, was five. Arriving into New York on August 14, 1848, aboard the Wiscasset from Glasgow, the Carnegies wasted little time settling in Allegheny City, Pennsylvania, a suburb of Pittsburgh, where relatives already existed and were there to provide help. Allegheny City provided Carnegie†s first job, as a bobbin boy in a cotton factory, working for $1. 20 a week. His father also worked there while his mother bound shoes at home, making a miniscule amount of money. Although the Carnegies lacked in money, they abounded in ideals and training for their children. At age 15, Carnegie became a telegraph messenger boy in Pittsburgh. He learned to send and decipher telegraphic messages and became a telegraph operator at the age of 17. Carnegie†s next job was as a railroad clerk, working for the Pennsylvania Railroad. He worked his way up the ladder, through his dedication and honest desire to succeed, to become train dispatcher and then division manager. At this time, young Carnegie, age 24, had already made some small investments that laid the foundations of his what would be tremendous fortune. One of these investments was the purchase of stock in the Woodruff Sleeping Car Company. In 1864, Carnegie entered the iron business, but did not begin to make steel until years later. In 1873, he built the Edgar Thomson works in Braddock, Pennsylvania, to make Bessemer steel. He established many other steel plants, and in 1892, he merged all of his interests into the Carnegie Steel Company. This act from Carnegie is fitting with one of his most famous quotations, â€Å"Put all of your eggs in one basket, and then watch that basket. † This firm became one of the greatest industrial enterprises in America. Carnegie later sold it to J. P. Morgan†s United States Steel Corporation in 1901 for $400 million, which would be a little over $4 billion today! After retiring, Carnegie†s fortune was estimated to be as large as half a billion dollars. From that time on, with the philosophy that the rich have a moral obligation to give away their money, he devoted himself to philanthropy. Although ironic, this man of great fortune strongly believed in the merits of poverty for the development of character and work ethic, and determined that wealthy men should not leave their fortunes to their children, but should give it away, claiming â€Å"The man who dies thus rich, dies disgraced. † The picture of community service, Carnegie is quoted as saying, â€Å"Pittsburgh entered the core of my heart when I was a boy, and cannot be torn out. I can never be one hair†s breadth less loyal to her, or less anxious to help her in any way, than I have been since I could help anything. My treasure is still with you, and how best to serve Pittsburgh is the question which occurs to me almost every day of my life. † Colonel James Anderson, who Carnegie believes to be his childhood benefactor, established a public library in his hometown of Allegheny City. This library was the first opportunity for Carnegie to take advantage of free information, and he developed a vast interest for knowledge, checking out at least one book a week, and developing himself as a young boy. With Colonel Anderson†s generous contribution to his society molding Carnegie†s childhood, and his beliefs on how large fortunes can be used for the betterment of society, it becomes obvious that Carnegie would focus particularly on promoting education, establishing 2,811 free libraries in all. Of these, 1,946 were located in the United States with at least one in every state except Rhode Island. Also, 660 were founded in Britain and Ireland, 156 in Canada, and a handful of libraries were also scattered in New Zealand, the West Indies, and even Fiji. Caregie†s contributions gave existence to his dream of establishing chances of self-education in a time when public libraries were scarce. Not only did he give large amounts of money to libraries, but also to other philanthropic organizations, establishing some of his own. The Carnegie Corporation of New York was established for â€Å"the advancement and diffusion of knowledge and understanding. † The $135 million donated by Carnegie was used in grants to colleges, universities, and other educational institutions. Money also went to organizations that conduct basic research and experimental programs dealing with education and public affairs. The Carnegie Endowment for International Peace was founded to promote international peace and understanding, conducting programs of research, discussion, publication, and education in the international affairs and United States foreign policy. Currently the program focuses on issues such as arms control, international law, and relations between the United States and foreign countries. It publishes the quarterly journal, Foreign Policy, and has offices in New York City and Washington, D. C. The Carnegie Foundation for the Advancement of Teaching promotes the dignity in the teaching profession and the cause of higher education. Chartered by Carnegie in 1905 with $15 million, the foundation established the Teachers Insurance and Annuity Association in 1918, and currently provides retirement pensions for teachers of colleges, technical schools, and universities in the United States and Canada. Their studies have had much influence on American higher education. Also benefiting from Carnegie†s charity include various Carnegie museums of history, science, and art, Carnegie Hall in New York, and other public spirited organizations. Before 1919, when Carnegie died, he had given away $350,695,653, and at his death, the last $30 million was likewise given away to foundations, charities, and pensioners. He left a mark on society not only through his enormous monetary provisions, but also with his own literature. Carnegie loved to promote his ideas and opinions in print, and has written many works outlining these philosophies, including Triumphant Democracy (1886), The Gospel of Wealth (1900), The Empire of Business (1902), Problems of Today (1908), and an Autobiography (1920) (Mitzen 182). Although Carnegie only stood somewhere between 5†³2†³ and 5†³6†³, he â€Å"had to be a great, tough, disciplined giant of a man. † His commitment to others is not only seen through his many munificent works, but in the way he lived, including his tombstone in the Sleepy Hollow Cemetery of North Tarrytown, New York, where the epitaph reads, â€Å"Here lies a man who was able to surround himself with men far cleverer than himself. â€Å" How to cite The Life of Andrew Carnegie, Papers

Nursing Case Study Comprehensive Nursing Care for Parkinsons Disease

Question: Discuss about theNursing Case Studyfor Comprehensive Nursing Care for Parkinson's Disease. Answer: Introduction Parkinson's disease is the disease of clinical diagnosis in which diagnosis mainly performed based on the observations by clinician. However, there is no definitive diagnostic test available for Parkinson's disease. Initial symptoms of Mrs. Downs include depression, stopped posture, fatigue, problem in walking, tremors and difficulty in arm swing. However, exhibition and progression of these symptoms varies from patient to patient. In such scenario, it would be difficult to make conclusive diagnosis. These symptoms appearing in the intimal stage of the disease and these are subtle, also these symptoms can be attributed to other conditions. In the age of Mrs. Downs these symptoms can be considered as age related conditions. Patients with Parkinson's disease are often expressionless and these patients are mistaken for depression. Long term consumption of Sinemet leads to dyskinesia, which is difficulty in movement. It reflects in Mrs. Downs through slow movement. Phenothiazine exaggera tes symptoms of Parkinson's disease, also it interferes with the action of dopamine. In case of Mrs. Downs, she is taking Sinemet which is a combination of levodopa and carbidopa. Sinemet acts through dopaminergic pathway. In past studies, it is evident that phenothiazine interferes with dopaminergic pathway. Hence, in case of Mrs. Downs phenothiazine interferes with action of Sinemet and there was less cure for the symptoms of Parkinson's disease in Mrs. Downs (Mocko et al., 2010; Pahwa Lyons, 2013)). In patients with Parkinson's disease there is the occurrence of the depression, lack of interest in doing things, anhedonia and anxiety. These patients exhibits lack of enjoyment in the activities which are enjoyable like watching movies, playing, music and sexual activities. Parkinson's disease patients are always worried about something which is irrelevant most of the time. Due to Parkinson's disease, family members of the patient also get affected. Family members feel burdened and stressed due the patient. Family members of the patient should assist in the daily activities of the patient. Patients with Parkinson's disease feel isolated form The society. This social isolation may also further exaggerate depressive behavior in the patient. Social isolation also leads to less movement in the patients. This less movement in patients with Parkinson's disease exaggerates other symptoms. Patients with Parkinson's disease are associated with cognitive problem and communication problem. Th ese things also lead to the isolation from the society (Rosenbaum, 2006). Proper diagnosis of the Parkinsons disease is very important. Because symptoms of the Parkinsons disease interfere with common symptoms of other diseases. Nurse should observe very closely patient, evaluate patients physical and psychological behavior and conclude on the diagnosis. By observing depression nurse should not make diagnosis as solely depression. Nurse should correlate different symptoms observed in the patient and make proper conclusion. Nurse should also consult experts from other fields like psychology experts and physiotherapist for making conclusive diagnosis. Nurse should refer to the previous case studies with the similar type of symptoms for making accurate diagnosis. Nurse should plan for the proper treatment for Parkinsons disease patient. Parkinsons disease treatment is mainly medication dependent. Nurse should select dose of the drug very carefully and dose should be in narrow range. Nurse should administer patient with dopaminergic drugs because these are the most effective drugs available for the treatment of Parkinsons treatment. If these drugs administered in less quantity, it would not produce desired effect. On the other hand, if these drugs administered in more quantity, it would produce physical and psychological disturbances like mental disturbance, disturbance in the sleep pattern and stiffness and rigidity. Nurse should also take into account administration of other drugs concomitantly along with dopaminergic drugs because vitamin B complex and phenothiazine affects action of dopaminergic drugs (Bunting-Perry Vernon, 2007). Palliative care should be provided to Mrs. Downs because she is suffering through Parkinsons disease. This disease is multifactorial disease and in this disease there is the physical and psychological disturbance in the patient. These conditions lead to the emotional, social and behavioral impact on the patient and family members of the patient. Palliative care is the multidisciplinary approach of managing chronic illness in elderly patients. Palliative care provides relief from symptoms, painful condition, physical and mental stress irrespective of the diagnosis. In case of Parkinsons disease also diagnosis is difficult and hence implementation of therapeutic strategy is difficult. In such scenario palliative care would be the optimum therapeutic approach for Mrs. Downs. Moreover, curative management of the Parkinsons disease is not available, hence management of Parkinsons disease remains pallitative. Due to Parkinsons disease, Mrs. Downs became disabled and dependent. Physical dis abilities in Mrs. Downs lead to the exaggeration of cognitive impairment and depression (Bunting-Perry Vernon, 2007). Stem cells are regenerating type of tissues, which can be converted into different type of tissues in the body. These newly formed tissues have the potential to maintain and repair tissues responsible for the disease conditions. This would prominently affect the development of the Parkinsons disease. Parkinsons disease is the neurodegenerative disease in which there is deficiency of dopamine. Currently available medications for the treatment of Parkinsons disease are dopamine agonist. These medications are helpful in the improvement in the early symptoms. However, long term use of the medications lead to the loss of dopaminergic neurons and after certain period of treatment these drugs become ineffective in Parkinsons disease patients. Treatment with stem cells proved useful in the improvement in Parkinsons disease symptoms and increase in dopamine level in the brain. Intracranial administration of stem cells in patients with Parkinsons disease provide neurotropic support and replace s dying dopaminergic neurons of the Parkinsons disease patient. Moreover, this stem cell therapy doesnt cause adverse effects like dyskinesia. Stem cell can release different chemical mediators like cytokines which can be useful in the differentiation of stem cells into the dopamine releasing neurons. Treatment with stem cells is proved to be beneficial in patients with Parkinsons disease. Parkinsons disease can be treated with stem cell transplantation. These stem cells are already in the phase 3 clinical trials. It reflects these stem cells exhibited effectiveness in both preclinical and clinical Parkinsons disease. Also, these stem cells exhibited safety profile in different toxicology models (Ambasudhan et al., 2016). Patients taking levodopa should not consume vitamin B complex concomitantly because vitamin B complex contains vitamin B6. Vitamin B6 potentiates transformation of levodopa to dopamine. Levodopa is the precursor of the neurotransmitter dopamine. This potentiating effect of vitamin B6 on levodopa may lessen effect of levodopa in patients with Parkinsons disease. Also, vitamin B6 stops the absorption of levodopa and it reduces its effect in Parkinsons disease. Mrs. Downs can take vitamin B complex along with levodopa however, its dose should be optimized. Vitamin B6 dose should not interfere with effectiveness of levodopa in Mrs. Downs. It has been well established that different doses vitamin B complex along with Sinemet exhibited different effects in Parkinsons disease (Prasad, 2016). References: Ambasudhan, R., Dolatabadi, N., Nutter, A., Masliah, E., Mckercher, S.R., Lipton SA. (2014). Potential for cell therapy in Parkinson's disease using genetically programmed human embryonic stem cell-derived neural progenitor cells. Journal of Comparative Neurology, 522(12), 2845-56. Bunting-Perry, L. K., Vernon, G. M. (2007). Comprehensive Nursing Care for Parkinson's Disease. Springer Publishing Company Mocko, J.B., Kern, A., Moosmann, B., Behl, C., Hajieva, P. (2010). Phenothiazines interfere with dopaminergic neurodegeneration in Caenorhabditis elegans models of Parkinson's disease. Neurobiology of Disease, 40(1), 120-9. Pahwa, R., Lyons, K. E. (2013). Handbook of Parkinson's Disease. CRC Press. Prasad, K. N., (2016). Fight Parkinson's and Huntington's with Vitamins and Antioxidants. Inner Traditions Bear Co. Rosenbaum, R. B. (2006). Understanding Parkinson's Disease: A Personal and Professional View. Greenwood Publishing Group.