Causes of Epilepsy and Seizures

Causes of Epilepsy and Seizures Contents (Jump to) Introduction to Epilepsy Seizures Causes of Epilepsy Conclusion References Figures Appendix Introduction to Epilepsy Epilepsy is the oldest known brain disorder dating back as early as 2080BC (Cascino et al., 1995). It was first identified as a disease by Dr Jon Hughlings Jackson in 1880 who defined it as â€Å"An occasional, sudden, massive, rapid and local discharge or the grey matter† (Scott, 1978). This definition has been confirmed 50 years later by Electroencephalography. A more recent definition was devised stating â€Å"Epilepsy is a neurological disorder in which the nerve cell activity in your brain is disturbed, causing a seizure during which you experience abnormal behaviour, symptoms and sensations, including loss of consciousness.†(Scambler, 1989) Worldwide, it is estimated that there are 65 million people living with epilepsy with almost 80% of the cases reported occurring in the developing world (Ngugi et al., 2010). Within the UK, the prevalence is between 1 in 40/70,000 which equates to 3% of the population will develop epilepsy in their lifetime. Recurrent seizures are the hallmark characteristic of an epileptic. If an individual has one seizure early in their lives then none thereafter, they are said to have had an epileptic seizure but do not suffer from epilepsy. (Duncan et al., 2006) Seizures A seizure is abnormally excessive neuronal activity localised to a particular area of the brain known as the cerebral cortex causing a disruption to normal brain function. These cortical discharges will transmit to the muscles causing convulsions or commonly referred to as a fit. Figure 1 Generalised seizure with neuronal activation in both hemisphere Classifying seizures is done based on the site of the brain which the seizure begins. This will be either; Partial – where the onset of seizure is localised to one part of the hemisphere (fig. 1), Generalised – where the onset of the seizure is across both hemispheres (fig. 2) or Secondary generalised – where a partial seizure later spreads to involve the majority of the 2 cerebral hemispheres (Duncan et al., 2006). Figure 2 Partial seizure with neuronal activation in one hemisphere The International League Against Epilepsy (ILAE) have defined 6 main types of seizures: Clonic, Tonic, Tonic-Clonic, myoclonic, absence and atonic (Solodar, 2014), with all having the shared characteristic of syncope. Tonic-clonic seizures (grand mal seizures) are the most common and typically last 30 seconds with an initial back arching motion (tonic phase), followed by severe shaking of body limbs (clonic phase) in which sufferers can become incontinent and bit their tongue (fig. 3). Myoclonic seizures consist of muscle spasms throughout the body, while absence seizures only display mild symptoms such as a slight head turn or repetitive eye blinking (Engel and Pedley, 2008). Figure 3 Tonic and Clonic phases of a seizure Causes of Epilepsy Majority of cases are termed idiopathic, meaning there is no known reason for the disorder in that individual. The difference in causes amongst the general population can be seen in figure 4. Genetic factors can causes epilepsy as can environmental factors. In general it is a combination of the two which go on to cause someone to become epileptic. Over 500 genes have been identified to be linked to the disorder if mutated with some making individuals more sensitive to environmental conditions that can initiate seizures (Sanchez-Carpintero Abad et al., 2007). Some symptomatic causes of epilepsy include; brain tumours, strokes, low oxygen during birth, head injuries during birth or during a person’s lifetime, infections such as meningitis or anything which causes damage to the brain (Chang and Lowenstein, 2003). Figure 4 Causes of epilepsy amongst the general population Conclusion Epilepsy is a condition which has a host of causes as have been highlighted. It is the category of seizure within the brain an individual has which will determine the type of seizure they have and the altered body state which is displayed. This can be a very distressing disorder for sufferers as they are unable to control when they have a seizure and could occur at a very dangerous time such as whilst driving. The effective management via medication, surgery or lifestyle changes can reduce a person’s chance of suffering future seizures. Unfortunately in the majority of cases, the cause is unknown. This makes it highly difficult to target the disease for a cure, therefore minimising the probability of a seizure is the next best thing. References CASCINO, G., HOPKINS, A. O. SHORVON, S. D. 1995. Epilepsy, London, Chapman Hall Medical. CHANG, B. S. LOWENSTEIN, D. H. 2003. Epilepsy. N Engl J Med, 349, 1257-66. DUNCAN, J. S., SANDER, J. W., SISODIYA, S. M. WALKER, M. C. 2006. Adult epilepsy. Lancet, 367, 1087-100. ENGEL, J., JR. PEDLEY, T. A. 2008. Epilepsy : a comprehensive textbook, Philadelphia, Pa. ; London, Wolters Kluwer/Lippincott Williams Wilkins. NGUGI, A. K., BOTTOMLEY, C., KLEINSCHMIDT, I., SANDER, J. W. NEWTON, C. R. 2010. Estimation of the burden of active and life-time epilepsy: a meta-analytic approach. Epilepsia, 51, 883-890. SANCHEZ-CARPINTERO ABAD, R., SANMARTI VILAPLANA, F. X. SERRATOSA FERNANDEZ, J. M. 2007. Genetic causes of epilepsy. Neurologist, 13, S47-51. SCAMBLER, G. 1989. Epilepsy, London, Tavistock / Routledge. SCOTT, D. 1978. About epilepsy, London, Duckworth. SOLODAR, J. 2014. Commentary: ILAE Definition of Epilepsy. Epilepsia, 55, 491. Figures ENGEL, J., JR. PEDLEY, T. A. 2008. Epilepsy : a comprehensive textbook, Philadelphia, Pa. ; London, Wolters Kluwer/Lippincott Williams Wilkins. – figures 1 2 http://www.doctortipster.com/10291-generalized-tonic-clonic-epilepsy-seizures-grand-mal-seizures-clinical-presentation.html figure 3 http://www.cureepilepsy.org/egi/about.asp figure 4 Appendix Reference Type: Book Record Number: 1988 Author: Cascino, Gregory, Hopkins, Anthony October and Shorvon, S. D. Year: 1995 Title: Epilepsy Place Published: London Publisher: Chapman Hall Medical Edition: 2nd ed / edited by Anthony Hopkins, Simon Shorvon and Gregory Cascino. Short Title: Epilepsy ISBN: 0412543303 :  ¹95.00 Accession Number: b9561325 Call Number: 616.853 20 British Library DSC 95/22799 British Library STI (B) GV 05 blsrissc Keywords: Epilepsy. Notes: GB9561325 bnb 2362 Previous ed.: 1987. Includes bibliographies and index. Research Notes: Useful book, especially for historical aspects. Uses different terminology for seizures than other material, possibly due to age of print Reference Type: Journal Article Record Number: 2037 Author: Chang, B. S. and Lowenstein, D. H. Year: 2003 Title: Epilepsy Journal: N Engl J Med Volume: 349 Issue: 13 Pages: 1257-66 Epub Date: 2003/09/26 Date: Sep 25 Short Title: Epilepsy Alternate Journal: The New England journal of medicine ISSN: 0028-4793 DOI: 10.1056/NEJMra022308 Accession Number: 14507951 Keywords: Cerebral Cortex/pathology/physiopathology Electroencephalography Epilepsy/classification/etiology/pathology/*physiopathology Hippocampus/pathology Humans Ion Channels/physiopathology Neuroglia/physiology Sclerosis Thalamus/physiopathology Notes: 1533-4406 Chang, Bernard S Lowenstein, Daniel H NS39950/NS/NINDS NIH HHS/United States Journal Article Research Support, U.S. Govt, P.H.S. Review United States N Engl J Med. 2003 Sep 25;349(13):1257-66. Research Notes: Good overview of the disorder with relevant sections around the causes Author Address: Comprehensive Epilepsy Center, Department of Neurology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, USA. Database Provider: NLM Language: eng Reference Type: Journal Article Record Number: 10337 Author: Duncan, J. S., Sander, J. W., Sisodiya, S. M. and Walker, M. C. Year: 2006 Title: Adult epilepsy Journal: Lancet Volume: 367 Issue: 9516 Pages: 1087-100 Epub Date: 2006/04/04 Date: Apr 1 Short Title: Adult epilepsy Alternate Journal: Lancet ISSN: 0140-6736 DOI: 10.1016/s0140-6736(06)68477-8 Accession Number: 16581409 Keywords: Adult Aged Anticonvulsants/adverse effects/*therapeutic use Drug Resistance/*genetics Electroencephalography *Epilepsy/diagnosis/drug therapy/physiopathology Humans Incidence Infant Pharmacogenetics Abstract: The epilepsies are one of the most common serious brain disorders, can occur at all ages, and have many possible presentations and causes. Although incidence in childhood has fallen over the past three decades in developed countries, this reduction is matched by an increase in elderly people. Monogenic Mendelian epilepsies are rare. A clinical syndrome often has multiple possible genetic causes, and conversely, different mutations in one gene can lead to various epileptic syndromes. Most common epilepsies, however, are probably complex traits with environmental effects acting on inherited susceptibility, mediated by common variation in particular genes. Diagnosis of epilepsy remains clinical, and neurophysiological investigations assist with diagnosis of the syndrome. Brain imaging is making great progress in identifying the structural and functional causes and consequences of the epilepsies. Current antiepileptic drugs suppress seizures without influencing the underlying t endency to generate seizures, and are effective in 60-70% of individuals. Pharmacogenetic studies hold the promise of being able to better individualise treatment for each patient, with maximum possibility of benefit and minimum risk of adverse effects. For people with refractory focal epilepsy, neurosurgical resection offers the possibility of a life-changing cure. Potential new treatments include precise prediction of seizures and focal therapy with drug delivery, neural stimulation, and biological grafts. Notes: 1474-547x Duncan, John S Sander, Josemir W Sisodiya, Sanjay M Walker, Matthew C Journal Article Research Support, Non-U.S. Govt Review England Lancet. 2006 Apr 1;367(9516):1087-100. Research Notes: Very good overview with clear explanation around neuronal activity of seizures Author Address: Department of Clinical and Experimental Epilepsy, Institute of Neurology UCL, Queen Square, London WC1N 3BG, UK. [emailprotected] Database Provider: NLM Language: eng Reference Type: Book Record Number: 10529 Author: Engel, Jerome, Jr. and Pedley, Timothy A. Year: 2008 Title: Epilepsy : a comprehensive textbook Place Published: Philadelphia, Pa. ; London Publisher: Wolters Kluwer/Lippincott Williams Wilkins Pages: 2797 Edition: 2nd ed. Short Title: Epilepsy : a comprehensive textbook ISBN: 9780781757775 (set) :  ¹173.00 0781757770 (set) :  ¹173.00 Call Number: 616.853 22 British Library DSC m07/.34665 vol. 1 British Library STI (B) 616.853 British Library DSC m07/.34666 vol. 3 British Library DSC m07/.34664 vol. 2 Keywords: Epilepsy. Notes: GBA771698 bnb editors, Jerome Engel Jr., Timothy A. Pedley ; associate editors, Jean Aicardi [et al.]. Previous ed. : c1998. Includes bibliographical references and index. Formerly CIP. Uk Research Notes: Had everything covered in good detail. Reference Type: Journal Article Record Number: 10335 Author: Ngugi, Anthony K., Bottomley, Christian, Kleinschmidt, Immo, Sander, Josemir W. and Newton, Charles R. Year: 2010 Title: Estimation of the burden of active and life-time epilepsy: a meta-analytic approach Journal: Epilepsia Volume: 51 Issue: 5 Pages: 883-890 Short Title: Estimation of the burden of active and life-time epilepsy: a meta-analytic approach ISSN: 0013-9580 DOI: 10.1111/j.1528-1167.2009.02481.x Abstract: To estimate the burden of lifetime epilepsy (LTE) and active epilepsy (AE) and examine the influence of study characteristics on prevalence estimates. Notes: 10.1111/j.1528-1167.2009.02481.x Research Notes: Only really useful for prevalence related material URL: http://dx.doi.org/10.1111/j.1528-1167.2009.02481.x Name of Database: READCUBE Reference Type: Journal Article Record Number: 11373 Author: Sanchez-Carpintero Abad, R., Sanmarti Vilaplana, F. X. and Serratosa Fernandez, J. M. Year: 2007 Title: Genetic causes of epilepsy Journal: Neurologist Volume: 13 Issue: 6 Suppl 1 Pages: S47-51 Date: Nov Short Title: Genetic causes of epilepsy Alternate Journal: The neurologist ISSN: 1074-7931 (Print) 1074-7931 (Linking) DOI: 10.1097/NRL.0b013e31815bb07d Accession Number: 18090951 Keywords: Animals Cerebral Cortex/physiopathology Epilepsy/*etiology/*genetics/pathology Humans Ion Channel Gating/genetics Ion Channels/genetics/*physiology Abstract: BACKGROUND: The contribution of genetic factors to the origin of different epilepsies is a fact established by epidemiological, clinical, and molecular studies. These studies have made it possible to identify numerous mutations in different genes that cause or predispose to the development of certain types of epilepsy. REVIEW SUMMARY: The study of single-gene epilepsies has contributed relevant data regarding the pathophysiology of epilepsy. Most of these genes encode voltage- or ligand-gated ion channels. Other single-gene epilepsies are related to mutations that provoke alterations in neuronal maturation and migration during embryonic development. Nevertheless, the most common forms of epilepsy are not caused by single mutations but by a combination of polymorphisms, most of which are unknown, that generate an alteration in neuronal excitability. In some syndromes, genetic alterations and their consequences have made it possible to explain the therapeutic response to diff erent drugs. Therefore, the progress being made in genetics is changing the classification and diagnosis of epilepsy; moreover, it can sometimes influence the choice of treatment. CONCLUSION: The advances made in genetic knowledge of epilepsy have led to the description of new epilepsy syndromes and to a better characterization of known ones. However, the genes responsible for the most common forms of idiopathic epilepsy remain mostly unknown. This means that for the time being, in clinical practice, genetic diagnosis is limited to uncommon syndromes and to cases in which treatment decisions or genetic counseling can be derived from the diagnosis. Notes: Sanchez-Carpintero Abad, Rocio Sanmarti Vilaplana, Francesc X Serratosa Fernandez, Jose Maria eng Research Support, Non-U.S. Govt Review 2008/01/26 09:00 Neurologist. 2007 Nov;13(6 Suppl 1):S47-51. doi: 10.1097/NRL.0b013e31815bb07d. Research Notes: Very complicated to read. Poorly illustrated. URL: http://www.ncbi.nlm.nih.gov/pubmed/18090951 Author Address: Pediatric Neurology Unit, Department of Pediatrics, Clinica Universitaria de Navarra, Pamplona, Spain. [emailprotected] Reference Type: Book Record Number: 2015 Author: Scambler, Graham Year: 1989 Title: Epilepsy Place Published: London Publisher: Tavistock / Routledge Short Title: Epilepsy ISBN: 0415017580 (pbk) : No price 0415017572 (cased) : No price Accession Number: b8920431 Call Number: 362.1/96853 19 British Library DSC 89/23194 British Library HMNTS YK.1989.a.5440 Keywords: Epileptics Psychology. Notes: GB8920431 bnb 2054 Graham Scambler. The Experience of illness Bibliography: p124-130. _ Includes index. Research Notes: Written with the patient in mind but lacks specific scientific data Reference Type: Book Record Number: 2011 Author: Scott, Donald F. Year: 1978 Title: About Epilepsy : revised Edition Place Published: [S.l.] Publisher: Duckworth Edition: 3rd Ed. Short Title: About Epilepsy : revised Edition ISBN: 0715609467 Call Number: British Library DSC 79/5721 Research Notes: Very well written with good scientific data to back up claims. Reference Type: Journal Article Record Number: 10484 Author: Solodar, J. Year: 2014 Title: Commentary: ILAE Definition of Epilepsy Journal: Epilepsia Volume: 55 Issue: 4 Pages: 491 Date: Apr Short Title: Commentary: ILAE Definition of Epilepsy Alternate Journal: Epilepsia ISSN: 1528-1167 (Electronic) 0013-9580 (Linking) DOI: 10.1111/epi.12594 Accession Number: 24731170 Keywords: *Advisory Committees Epilepsy/*classification/*diagnosis Female Humans Male *Research Report *Societies, Medical Notes: Solodar, Jessica eng Comment 2014/04/16 06:00 Epilepsia. 2014 Apr;55(4):491. doi: 10.1111/epi.12594. Epub 2014 Apr 14. URL: http://www.ncbi.nlm.nih.gov/pubmed/24731170 Research Notes: Good summary of definitions around seizures and all terminology within epilepsy 1

Metaphors in the Mechanical Engineering Field :: Language Linguistics

Metaphors in the Mechanical Engineering Field The Mechanical Engineering field involves multiple disciplines. The language from the disciplines converges into a complex dialect of sayings and metaphors. Metaphors are used in the field as â€Å"a figure of speech in which a word or phrase that ordinarily designates one thing is used to designate another, thus making an implicit comparison† [1]. The Mechanical Engineering field entails different working environments and types of employment. The metaphors CAD jockey, cube farm, and worth his salt encapsulate different aspects of a Mechanical Engineer. In everyday life common metaphors like tie the knot, pass the buck, and pushing the envelope are used. Pushing the envelope means, â€Å"to approach or exceed known performance boundaries† [2]. The origin is from â€Å"US Air Force test pilot program of the late 1940’s.† The envelope refers to an aircraft’s performance and is difficult to comprehend. It is not clear why the envelope is related to an aircraft’s performance. This comparison is confusing and can mislead people in understanding the concept of the metaphor. The concept of pass the buck is â€Å"pass off responsibility to someone else.† In some card games a marker called buck is used. The marker is used to signify the dealer and the person responsible to deal the cards. Players take turns as the dealer by passing the marker. People familiar with the name of the marker will understand the meaning of this metaphor. The metaphor tie the knot has been used since ancient times to represent the act of marriage. During antiquity, in many parts of the world only, a priest or patriarch knotted together the garments of the bride and groom to symbolize a permanent union [3]. This metaphor has been used for years and is known around the world. It is hard to understand the meaning from the word usage. The meaning of a CAD jockey is a person that uses computer-aided design tools. The origin is around the 1990’s when computer-aided design tools became available to the general public. The metaphor is appropriate for a person that uses computer-aided design tools. Someone not familiar with the acronym CAD will be confused by this metaphor. The metaphor cube farm is â€Å"an office filled with cubicles† [4]. This metaphor began in the 1970’s when cubicles sprang up in the office landscape. The phrase usually has negative connotations about the working environment, which are that the environment is stressful and noisy.

Code of Ethics Paper Essay

According to Cancer Treatment Center of America (2013), since 1988, Cancer Treatment Centers of America ® (CTCA) has been helping patients win the fight against cancer using advanced technology and a personalized approach (About Us). Each hospital provides state-of-the-art cancer treatment by a dedicated team of oncologists, surgeons and other health experts. They offer a welcoming environment, where patients and their family members can find comprehensive cancer care under one roof. The vision of the CTCA is to be recognized and trusted by people living with cancer as the premier center for healing and hope. The organizational goals of the CTCA are to benefit the patient by providing powerful and innovative therapies to heal the whole person, improve quality of life and restore hope. Organizational goals According to Cancer Treatment Centers of America (2013), â€Å"You and your healing are at the center of our hearts, minds and actions, every day. We rally our team around you, delivering compassionate, integrative cancer care for your body, mind and spirit† (Cancer Experts Who Care). Organizational goals that are within the Cancer Treatment Centers of America (CTCA) are to provide patient care with, compassionate, appropriate and effective to assess and treatment be honest. Make informed decisions about diagnostic and therapeutic interventions based on patient information and preference, documented scientific evidence and clinical judgment. To create and sustain therapeutic and ethically sound relationships with patients and with these goals and objectives are designed to provide advanced training in the assessment and cancer treatment. An objective of the CTCA is to increase the participation of institutions serving racial/ethnic and/or underserved communities with cancer health disparities in the nation’s cancer research and training enterprise. Also, to develop more effective research, outreach, and education programs that will have an impact on ethnic minority and the  underserved populations. Corporation’s Ethical Values The roles of the company are making sure their patients come first, their main focus is not about fighting cancer, and it’s about making sure their patients are comfortable throughout treatment. The cancer treatment statistics and results of CTCA demonstrate their constant efforts to make a difference when it comes to quality of their patients. Each of their hospital provides state of the art treatment with a dedicated team which is oncologists, surgeons and other health experts. Their mission is to keep search for a cure and to continue to keep their patients in good spirits, they do not give up until they have answers. CTCA is accredited by The Joint Commission (formerly Joint Commission on Accreditation of Healthcare Organizations, or JCAHO) with Full Standards Compliance. This accreditation decision is awarded to a healthcare organization that demonstrates satisfactory compliance with applicable Joint Commission standards in all performance areas. The Cancer Center of America knows that cancer patients want their treatment to incorporate the needs of the whole person—physically, emotionally and spiritually. We know they value greatly a multidisciplinary care team that will be responsive to their personal needs throughout treatment. Organization’s Culture and Ethical Decision-Making The Cancer Treatment Center of America organization believes there is more than one way to beat cancer. There are so many people diagnosed with cancer and do not know which way to turn, confused, and angry. The cultural of the organizations is friendly, compassionate, and they treat each patient that comes into the center and gives them all the support that they need. The Cancer Treatment Center treats all types of cancer, and makes you feel welcome from the first day you arrive. Coming to the center, treated with respect and the moral decisions made by you they are behind you a hundred percent. The center is a place that never gives up on trying making a person feel better about their self. The Cancer Treatment Center of America has a vision, and that statement says â€Å"To be recognized and trusted by people living with cancer as the premier center for healing and hope† (Cancer  Centers of America, 2013). Not only does the center treat individuals that have cancer, but they also educate those who are not aware of what cancer is. It is a center for learning as well. No patient is turned down when they come to the center. According to Cancer Treatment Center of America (2013), â€Å"You and your healing are at the center of our hearts, minds and actions every day. We rally our team around you, delivering compassionate, integrative cancer care for your body, mind and spirit. We offer clear information, powerful and thorough treatment options, all based on your needs. We honor your courage, respect your decisions, and offer to share your journey of healing and hope† (Our Promise). Organization’s Ethical Values vs. Individual’s Ethical Values It is important that an organization such as Cancer of America ethical support an individual’s ethical value because of several reasons. If an employee’s ethical value does not coincide with the organizations ethical value it can cause increased stress levels while performing their daily duties. In addition, conflicts can arise due to an individual’s personal ethical values, which can cause stress and eventually lead to work place anger and hostility. Furthermore, dissatisfied employees in regards to organizational value could inadvertently or purposely sabotage the company. For example, an organization’s ethical value gives the patient’s family the authority to decide for the patient since the patient is on life support. The patient’s family member decides not to terminate the patient’s life support because the patient’s family depends on the patient’s social security funds. Your individual personal values do not agree with this because the patient is ventilator dependent, non-responsive to treatment, lacks neurological function and is terminally ill. With this case your ethical values are being affected. Values are the principles that everyone uses to define what is right, good, and just to them. Values provide guidance as it determines the proper thing to do versus what is incorrect. They are our standards, which is the reason why the organizational value should match an individual’s values. Social Responsibility The founder of Cancer Centers of America or CTCA Cancer Treatment Center of  America, Richard J. Stephenson, definitely felt he had a social responsibility for all those in need of care. He felt as if there was not enough compassion, attention and nurturing, to those that were going through physical and emotional changes. Because his mother passed away due to cancer, he felt that it was needed to introduce an all-around care facility that provided surgery, chemotherapy, nutrition, mind-body medicine, and spiritual support (Cancer Center of America). Through their website, they host a community Question’s and Answer’s online that is answered by doctors and clinical experts about questions that you have related to cancer. They also have an 800 number that you can call with your questions related to your cancer, location information and their services. On their website there are cancer survivors stories that you can read/watch that go into full detail about their experience at the facilities. I believe that when you share your vision of making something or someone better, your mission as how you will get there and making a promise to utilize all your resources to try, simply try, on making someone else’s life a little bit better, that is responsibility in itself. CTCA offers clear information, powerful and thorough treatment options, all based on your needs. They honor your courage, respect your decisions, and offer to share your journey of healing and hope. The Mission of Cancer Treatment Centers of America ® is the home of integrative and compassionate cancer care. We never stop searching for and providing powerful and innovative therapies to heal the whole person improve quality of life and restore hope. The vision at the CTCA is to be recognized and trusted by people living with cancer as the premier center for healing and hope. Lastly, they promise you and your healing are at the center of our hearts, minds and actions every day. We rally our team around you, delivering compassionate, integrative cancer care for your body, mind and spirit (Cancer Center of America). Conclusion The Cancer Treatment Centers of America is the home of integrative and compassionate cancer care. Their goal is to serve cancer patients with the best care possible, the most advanced technology, the most recent studies, and the most nurturing staff. At CTCA they believe there is not one way to beat cancer – there are hundreds. According to Garrett, Baillie, and  McGeehan (2010), the health care professional is obliged to protect patients from harm as much as is possible (Chapter 12). The teams of cancer experts include oncologists, surgeons and other clinicians who meet regularly to discuss the progress of each patient’s treatment. The ethical decisions that each member of the medical staff make are in the absolute best interest of the cancer patients and their treatment. The Cancer Treatment Center treats all types of cancer, and makes you feel welcome from the first day you arrive. They offer clear information, powerful and thorough treatment options, based on patient’s needs, as they are at the center of the hearts, minds, and every day actions of the dedicated staff (Cancer Treatment Center of America, 2013). References Cancer Treatment Centers of America. (2013). Retrieved from http://www.cancercenter.com/about-us/ Cancer Treatment Centers of America. (2013). Retrieved from http://www.cancercenter.com/patient-experience/your-treatment/cancer-experts Garrett, T.M., Baillie, H.W., & McGeehan, J.F. (2010). Health Care Ethics (5th ed.). Retrieved from The University of Phoenix eBook Collection database.

Definition and Examples of Verbal Play in English

The term verbal play refers to the playful and often humorous manipulation of the elements of language. Also known as logology,  word play,  speech play, and verbal art. Verbal play is an integral characteristic of language use and an  important component in the process of language acquisition.   Examples and Observations Whats the difference between the Prince of Wales and a tennis ball?One is heir to the throne and the other is thrown into the air.The value of marriage is not that adults produce children but that children produce adults.(Peter De Vries, The Tunnel of Love, 1954)I understand your new play is full of single entendre.(George S. Kaufman to fellow playwright Howard Dietz)Child: Mommy, can I go out and play?Mother: With those holes in your pants?Child: No, with the girl next door.Your mama is so  skinny she can hula-hoop a Cheerio.Dear Sir or Madam or Sodom or Whom It May Confirm:I understand you are hiring programmers and hereby present my amplification for annoyment by your firm. As you see, I see, juicy lucy goosy poosy, I have long expedience in grammar and was medicated in the best schools and my dram is to ride underwear. On my clothes is my consomme. Please feel free.I remain your humble serpent.(James Joyce Business School,  A Prairie Home Companion, March 4, 2000)Sense and No nsenseVerbal play, though independent of sense, does not need to be nonsense; it is indifferent to, but not in opposition to, meaning. Verbal play  is  actually an appeal to reason with the intention of suspending its inhibitive power.(Leonard Falk Manheim,  Literature and Psychology, 1988)Speech Play and Verbal ArtThe boundaries between speech play and verbal art are hard to delimit and are cultural as well as linguistic. At the same time, there are certain verbal forms where the relationship between the two is particularly salient and where it is quite clear that forms of speech play constitute the building blocks of verbal art. These include most particularly the stretching and manipulation of grammatical processes and patterns, repetition and parallelism, and figurative speech. Typically verbal art is characterized by combinations of these forms of speech play.(Joel Sherzer, Speech Play and Verbal Art. University of Texas Press, 2002)Verbal Play  in African American Comm unities- Verbal play in the African American community is both performance and entertainment, oriented like sandlot football or card playing at picnics. But it can, on occasion, be as serious a kind of play as competitive football or bid whist tournaments.(T. Garner and C. Calloway-Thomas, African American Orality: Expanding Rhetoric. Understanding African American Rhetoric, ed. by R. L. Jackson and E. B. Richardson. Routledge, 2003)- In inner-city communities where black English is spoken . . . certain styles of  verbal play  are commonly practiced and highly valued. Such play involves both play with language and provocative play with social conventions. Individual social standing in part depends on the command of these highly structured types of repartee and the ability to keep cool while giving and receiving outrageous insults or challenges to self-esteem. Young children in such communities gradually learn this style of verbal play, using one-liners at first, but often accide ntally giving or taking real offense before they understand how to use the techniques creatively and with the proper emotional distance.(Catherine Garvey, Play. Harvard University Press, 1990)