Sunday, January 26, 2020
Political And Constitutional Struggle Of Quaid History Essay
Political And Constitutional Struggle Of Quaid History Essay The dynamic leadership and remarkable services of Quaid-e-Azam Mohammad Ali Jinnah in the Pakistan Movement of freedom and independence is slave to no introduction. In this movement, the personality of Quaid-e-Azam; his tireless efforts and immense struggle made the crude and difficult path for the freedom of Pakistan very easy. The Muslims of India finally succeeded in achieving their destination for which they underwent a long, painful yet motivated journey led by the Quaid. POLITICAL AND CONSTITUTIONAL STRUGGLE OF QUAID: Jinnahs arrival and stay in London was the sowing time. The first decade in Bombay, after his return from Britain, was the germinating period; the later decade (1906-1916) marked the vintage stage. It could also be called a period of idealism, as Jinnah was a romanticist both in personal and political life. As Jinnah came out of his shell, the political limelight shone on him. He was budding as a lawyer and flowering as a political activist. A political child during the first decade of the century, Jinnah had become a political giant before Gandhi even returned to the Indian sub-continent from South Africa. THE DIFFERENCES OF JINNAH WITH THE CONGRESS: Mohammad Ali Jinnah differed with Gandhi on the means of achieving self-rule. The League session reassembled at Lahore under Jinnahs presidency and was attended by a number of Congressmen and leaders of the Khilafat Movement. The Quaid, despite his differences with Mahatma Gandhi and the Khilafists, still enjoyed the trust and admiration of the Muslims of Bombay which can be seen from the fact that he won the Bombay Muslim seat for the Legislative Assembly that he had resigned in protest against the Rowlett Act. DELHI PROPOSALS 1927: Due to the deep distrust between the two communities as evidenced by the country-wide communal riots and because the Hindus failed to meet the genuine demands of the Muslims, his efforts came to naught. One such effort was the formulation of the Delhi Muslim Proposals in March, 1927. In order to bridge Hindu-Muslim differences on the constitutional plan, these proposals even waived the Muslims right to separate electorate, the most basic Muslim demand since 1906, which though recognized by the congress in the Luck now Pact, had again become a source of friction between the two communities. QUAIDS FOURTEEN POINTS 1929: In 1928, Pundit Moti Lal Nehru presented a report which turned down all the Muslims demand. On the reply of Nehru report, Mohammad Ali Jinnah presented his famous fourteen points on March 28, 1929 to the Muslim League Council at their Session in Delhi. Since all the Muslims opposed the Nehru Report, these points were to counter the proposals made in the Nehru Report. This was the certainly the right answer to the Nehru report. The points were to recommend the reforms that would defend the rights of the Muslims of the sub-continent. The points are following: 1- The form of the future constitution should be federal, with the residuary powers to be vested in the provinces. 2- A uniform measure of autonomy shall be granted to all provinces. 3- All legislatures in the country and other elected bodies shall be constituted on the definite principle of adequate and effective representation of minorities in every province without reducing the majority in any province to a minority or even equality. 4- In the Central Legislature, Muslim representation shall not be less than one third. 5- Representation of communal groups shall continue to be by separate electorates: provided that it shall be open to any community, at any time, to abandon its separate electorate in favor of joint electorate. 6- Any territorial redistribution that might at any time be necessary shall not in any way that would affect the Muslim majority in the Punjab, Bengal and the NWFP. 7- Full religious liberty i.e. liberty of belief, worship, and observance, propaganda, association, and education, shall be guaranteed to all communities. 8- No bill or resolution or any part thereof shall be passed in any legislature or any other elected body if three fourths of the members of any community in that particular body oppose such a bill, resolution or part thereof on the ground that it would be injurious to that community or in the alternative, such other method is devised as may be found feasible practicable to deal with such cases. 9- Sindh should be separated from the Bombay Presidency. 10- Reforms should be introduced in the NWFP and Baluchistan on the same footing as in other provinces. 11- Provision should be made in the Constitution giving Muslims an adequate share along with the other Indians in all the services of the State and in local self-governing bodies, having due regard to the requirements of efficiency. 12- The Constitution should embody adequate safeguards for the protection of Muslim culture and for the protection and promotion of Muslim education, language, religion and personal laws and Muslim charitable institutions and for their due share in the grants-in-aid given by the State and by local self-governing bodies. 13- No cabinet, either Central or Provincial, should be formed without there being a proportion of at least one-third Muslim ministers. 14- No change shall be made in the Constitution by the Central Legislature except with the concurrence of the States constituting the Indian Federation. SECOND ROUND TABLE CONFERENCE 1931: The Hindu Muslim dispute must be settled before the enforcement of system or constitution. Until you do not give guarantee for the safeguard for the Muslims interests, until you enforce shall not last for even 24 hours. REORGANIZATION: Jinnahs disillusionment at the course of politics in the subcontinent prompted him to migrate and settle down in London in the early thirties. While in England, the Quaid had been watching the events that were happening in India and was saddened to see how Muslim interests were being sacrificed by the chaotic situation within the Muslim League. The Muslim League was in the hands of rich, landlords or some middle class intellectuals with limited horizons, while the All India Congress was emerging as the leading party for Indian Independence. He was, however, to return to India in December 1933, at the pleadings of his co-religionists, and assume their leadership. Jinnah realized that organizing the Muslims of India into one powerful and dynamic organization was badly needed. He performed two important tasks after his return from England, the first was to unite and activate the Muslim League as the sole representative body of the Muslims of India. The second was to continue the struggle for freedom of India on constitutional lines. Undismayed by this bleak situation, Jinnah devoted himself with singleness of purpose to organizing the Muslims on one platform. He embarked upon country-wide tours. He pleaded with provincial Muslim leaders to sink their differences and make common cause with the League. He exhorted the Muslim masses to organize themselves and joined the League He gave coherence and direction to Muslim sentiments on the Government of India Act, 1935. He also formulated a viable League manifesto for the election scheduled for early 1937. He was, it seemed, struggling against time to make Muslim India a power to be reckoned with. Despite all the manifold adds stacked against it, the Muslim League won 108 (about 22 percent) seats out of a total of 492 Muslim seats in the various legislatures. Though not very impressive in itself, the Leagues partial success assumed added significance in view of the fact that the League won the largest number of Muslims and that it was the only All-India party of the Mu slims in the country. Thus, the elections represented the first milestone on the long road to putting Muslim India on the map of the subcontinent. LUCKHNOW SESSION: Jinnah utilized all his energies on revitalizing the League. With the assistance of the Raja of Mahmudabad, a dedicated adherent of the Muslim League, the Lucknow Session was a grand demonstration of the will of the Muslims of India to stand up to the Congress challenge. It was the Lucknow Session that Jinnah persuaded Sir Sikander Hayat Khan to join the Muslim League along with his Muslim colleagues. That development later became famous as the Jinnah-Sikander Pact. This Session marked a dramatic change not only in the Leagues platform and political position, but also in Jinnahs personal commitment and final goal. He changed his attire, shedding the Seville Row suit in which he had arrived for a black Punjabi sherwani long coat. It was for the first time he put on the compact cap, which would soon be known throughout the world as Jinnah Cap. Ti was at that session that the title of Quaid-e-Azam (the great leader) was used for Jinnah and which soon gained such currency and popularity that it almost became a substitute for his name. The great success was achieved the organization front of the Muslim League. Within three months of the Lucknow session over 170 new branches of the League had been formed, 90 of them in the United Provinces, and it claimed to have enlisted 1,00,000 new members in the province alone. DAY OF DELIEVERANCE 22 DECMEBER 1939: The Second World War broke out in 1939 and the British Government was anxious to win the favor and co-operation of the major political parties and leaders in their war effort. The Viceroy made a declaration in October assuring the people of India that after the war, the constitutional problems of India would be re-examined and modifications made in the Act of 1935, according to the opinion of India Parties. The Congress reacted to that drastically, condemned the Viceroys policy statement and called upon the Congress ministries to resign by October 31, 1939. On the resignation of the Congress ministries, the Muslim League appealed to the Muslims and other minorities to observe December 22, 1939 as the Day of Deliverance. DEMAND FOR PAKISTAN (23 RD MARCH 1940): Quaid-e-Azam said in the words; We are a nation with our own distinctive culture and civilization, language and literature, art and architecture, names and nomenclature, sense of values and proportion, legal laws and moral code, customs and calendar, history and tradition, aptitudes and ambitions, in short, we have our own distinctive outlook on life and of life. By all canons of international law, we are a nation. The formulation of the Muslim demand for Pakistan in 1940 had a tremendous impact on the nature and course of Indian politics. On the one hand, it shattered forever the Hindu dreams of a pseudo-Indian, in fact, Hindu Empire exit from India: on the other, it heralded an era of Islamic renaissance and creativity in which the Indian Muslims were to be active participants. The Hindu reaction was quick, bitter and malicious. Addressing on 23rd march 1940 he said that: The Mussalmans are not minority. They are a nation by any definition. By all canons of international law, we are nation He also said that: India is not a nation, nor a country. It is a sub-continent of nationalities. Hindus and Muslims being the two major nations. The Hindus and Muslims belong to two different religious, philosophies, social customs and literature. It is quite clear that Hindus and Muslims derive their inspiration from different sources of history CRIPPS MISSION 1942: Sir Stafford Cripps was sent by the British Government to India in March 1942, to discuss with Indian leaders, the future Indian Constitution. His proposal was rejected by both the Congress and the League. The Congress characterized them as a post-dated cheque on a failing bank. Jinnah in his presidential address to the Allahabad session of the League, analyzed the Cripps proposals and expressed the disappointment that if these were accepted Muslims could become a minority in their majority provinces as well. DIVIDE AND QUIT 1942: The failure of the Cripps Mission, though unfortunate in many ways, resulted in strengthening of the Muslim League case of Pakistan. The Congress decided to launch its final assault on British imperialism in the movement that came to be known as the Quit India movement. Gandhi called upon the people to take initiative and to do or die in a last struggle for freedom, throwing of the initial pretences of non-violence. He did not consult the Muslim League or any other party and went ahead with his plans in the hope that the momentum of the mass movement would take violent forms and would involve all parties and sections of the people of India. To the Congress slogan of Quit India, the Quaids answer was Divide and Quit which meant Muslims do not only want freedom from British but also from Hindu Raj. JINNAH-GANDHI TALK 1944: The two leaders also differed with regard to the boundaries of Pakistan and how the issue of whether India should be divided at all, was to be determined. Gandhi was adamant on the question of partition and although he appeared to be conceding the possibility of partition he did everything he could to persuade the Quaid to give up his demand of the establishment of two sovereign states. The British had been watching with anxiety the progress of the Jinnah-Gandhi talks and were making plans to meet the situation if the Congress and the League arrived at an agreement. The failure of these talks spurred the Viceroy to make renewed efforts to break the political deadlock in India. Though the Gandhi-Jinnah negotiations failed to achieve the avowed goal of the Hindu-Muslim unity, they brought to Jinnah and the Muslim League two important political gains. Firstly, the leadership of the Congress had now offered to discuss the questions of Pakistan seriously before that, the Congress and Mahatma had kept the door to that subject uncompromisingly shut. Secondly, the Congress could no longer justifiably claim that it stood for all the communities in India including the Muslims. Louis Feisher wrote: The wall between Jinnah and Gandhi was the Two Nation Theory. QUAID E AZAM AND TWO NATION THEORY: Quaid -e-Azam was a firm advocate of two nation theory which becomes the ideological basis Pakistan. He considered the Muslim as a separate nation. He said: Pakistan was created the day the first Indian nation entered the field of Islam He explained the two nation theory as: The Muslims are the nation by every right to establish their separate homeland. They can adopt any means to promote and protect their economic social political and cultural interests SIMLA CONFERENCE 1945: As per the provisions of the Wavell Plan, the Executive Council would be reorganized and Hindus and Muslims would equally represent in the Viceroys Executive Council and the Council would work as Interim Government till the end of war. Lord Wavell called a conference at Simla in June 1945 to give a practical shape to this plan. The Quaid-e-Azam insisted that the right to appoint five Muslim members in the Executive Council should entirely rest with the Muslim League. That was not acceptable to the Congress as the Congress claimed to represent both the Hindus and Muslims. The conference failed to achieve any purpose due to one-sided attitude of Lord Wavell. In this conference, Quaid-e-Azam made it crystal clear that only the Muslim League can represent Muslims of India. ELECTIONS: Elections for the central and provincial assemblies were held in 1945-46. Muslim League managed to win all the 30 seats reserved for the Muslims in central legislative and 427 seats out of 495 Muslim seats in the provincial legislative. Election results were enough to prove that Muslim League, under the leadership of Quaid-e-Azam, was the sole representative of the Muslims of the region. Quaid-e-Azam said on this occasion I have no doubt now in the achievement of Pakistan. The Muslims of India told the world what they want. No power of world can topple the opinion of 10 crore Muslims of India. DELHI CONVENTION 1946: On 19th April 1946, soon after the elections, Jinnah called a convention at Delhi of all the newly elected. League members in the central and the provincial legislatures. In this convention the word States of 1940à ¢Ã¢â ¬Ã ²s Lahore Resolution is transformed into the word State and the legislators signed pledges solemnly declaring their firm conviction that the safety, security, salvation and destiny of the Muslims lay only in the achievement of Pakistan. CABINET MISSION PLAN 1946: The most delicate as well as the most tortuous negotiations began with the arrival, in March 1946, of a three-member British Cabinet Mission. The crucial task with which the Cabinet Mission was entrusted was that of devising in consultation with the various political parties, constitution-making machinery, and of setting up a popular interim government. But, because the Congress-League gulf could not be bridged, despite the Missions prolonged efforts, the Mission had to make its own proposals in May 1946. The Muslim League accepted the plan on June 6, 1946. The Congress accepted the plan on June 25, 1946, though it rejected the interim setup. The Viceroy should now have invited the Muslim League to form Government as it had accepted the interim setup; but he did not do so because he did not want to make Congress angry. So in this situation Cabinet Mission went back to England on June 29 without deciding anything. DIRECT ACTION DAY 16TH AUGUST 1946: The Council of the All-India Muslim League met in Bombay and on July 27, 1946 it finally sealed its rejection of the Cabinet Mission Plan, and decided to launch its famous Direct Action for the achievement of Pakistan, which it could not achieve by peaceful means due to the intransigence of Congress on the one hand and the breach of faith with the Muslim by the British Government on the other. Quaid-e-Azam Muhammad Ali Jinnah said Never have we in the whole history of the League done anything except by constitutional methods. But now we are forced into this position. Today we bid good-bye to constitutional methods. Today we have forged a pistol and are in a position to use it. We mean every word of it. We do not believe in equivocation. Direct Action Day was celebrated on 16th August 1946. There was a strike in all over the country that they. Direct Action Day was observed peacefully throughout India, except in Calcutta, where riots broke out. PARTITION DAY 1947: By the close of 1946, the communal riots had flared up to murderous heights, engulfing almost the entire subcontinent. The two people, it seemed, were engaged in a fight to the finish. The time for a peaceful transfer of power was fast running out. Realizing the gravity of the situation, His Majestys Government sent down to India a new Viceroy Lord Mountbatten. His protracted negotiations with the various political leaders resulted in 3 June (1947) Plan by which the British decided to partition the subcontinent, and hand over power to two successor States on 15 August, 1947. The plan was duly accepted by the three Indian Parties to the dispute the Congress, the League and the Akali dal (representing the Sikhs). However Pakistan became constitionally independent at midnight between 14th and 15th August 1947. IDEOLOGY OF PAKISTAN: The Pakistan Resolution explains the ideology of Pakistan, establishment of homeland in the north-western and eastern zone of India where the Muslims should be free to lead their lives according to the tenets of Islam. This Resolution implied the independence of these two states from India but it did not imply independence of one another, for the subsequent league Resolution of April 1946 spoke of east and west Pakistan as one sovereign state. ALL INDIA MUSLIM LEAGUE: On march 26, 1939, it was announced that the working committee of the All-India Muslim league had set up a committee to examine the various constitutional proposals which had already been made regarding the future constitution of India. This committee was also to consider constitutions of other countries and was then to report its conclusions at an already date to the working committee. Several schemes had been put forward by Muslim leaders: some suggested two or three separate federations while other recommended an all-India federation of the regions comprising Muslim, Hindu, and other areas. CONTITUTIONAL ASSEMBLY: The constitutional assembly started functioning in January 1947. The Muslim league demanded its dissolution on the basis that the British Governments interpretation of the plan was not accepted by the Sikh and the Scheduled Castes and that the session and proceedings of the assembly were invalid. THE FIRST CABINET OF PAKISTAN: The first Cabinet of Pakistan was the creation of the Quaid-e-Azam. Liaqat Ali Khan was named by him as the prime minister, a position to which he was entitled by virtue of his position in the Muslim league party which had an over-whelming majority in the assembly. Since he owed the leadership of the legislature also to the Quaid-e-Azam, Liaqat had no say in the selection of his colleagues, whose name and the portfolios they were to hold, were simultaneously announced along with his own appointment. More than one minister subsequently made public declaration to the effect that he was a nominee of the Quaid-e-Azam. The Cabinet was broadly representative of the provinces as also of the refuges from India and minorities LEADER OF A FREE NATION: In recognition of his singular contribution, Quaid-e-Azam Mohammad Ali Jinnah was nominated by the Muslim League as the Governor-General of Pakistan, while the Congress appointed Mountbatten as Indias first Governor-General. Pakistan, it has been truly said, was born in virtual chaos. The problems which the Quaid-e-Azam had to face as Governor General of Pakistan were not only due to the happenings in East Punjab, and to provide shelter for the millions of refugees. What immensely increased the difficulties of the new state was the fact that it had yet to organize itself. CONCLUSION: After the tireless and undying efforts and struggles of our great Quaid and others leaders, finally Pakistan emerged on the map of the world as an independently existing nation. We live freely in our nation, as individuals of a distinctive identity and enjoy our social, political and economic interests regardless of the fears and traumas our fore fathers have faced. The peaceful sleep at night which we get now has undoubtedly emerged as a result of the great vision of Iqbal and the remarkable and tremendous leadership and guiding light of none other than the father of our nation; Mr. Muhammad Ali Jinnah; Quaid e Azam.
Saturday, January 18, 2020
Symbolism in the Red Convertible
October 1st, 2012 Symbolism in the Red Convertible In writing, authors use symbolism to relay a deeper meaning to what they actually write. This technique captures important elements and gives the reader an idea of the theme of the story without the author directly telling them. Louise Erdrich uses symbolism to help emphasize and reveal the themes and message of her stories. ââ¬Å"The Red Convertible,â⬠by Erdrich, is a story about brotherly love as the highest value between two brothers, Lyman and Henry, and also about the difficulties veterans of war and their families face at post-war times.Symbolism plays a big part in this story, revealing the hardships Henry brings home from the battlefields of Vietnam, and to show Lyman's difficulties with handling separation and distance from his brother. The story is told from Lyman Lamartineââ¬â¢s point of view as he recounts the relationship he had with his older brother, Henry. He says how they both bought a red Oldsmobile conver tible on impulse and traveled the country with it. He recalled it as a very happy and carefree time between the brothers. Then Henry went off to fight in the Vietnam War and when he returned he was a very changed man.He was depressed and lost interest in everything, including the car and his brother. When Lyman realizes the relationship between him and his brother will never be the same, he takes a hammer and beats the car up so it is in horrible condition. Henry sees the broken car and fixes it up. Once finished, the boys drive the car to a lake andà Henry tries to give Lyman complete ownership of the car but Lyman constantly refuses. The brothers enjoy a tiny moment of laughter and hopefulness and after spending a couple good minutes together, Henry tells Lyman that he needs to cool off, and he jumps into the river.Apathetically, Henry says that his boots have filled with water and he goes under in the current. Lyman tries to save his brother but canââ¬â¢t. Then he turns the car on and sends it into the river, watching it sink to its demise just like Henry. The red convertible could be seen as a symbol of attachment. The two brothers by the car on impulse, using all the money they had with them, and soon it becomes their source of fun, adventure, and relaxation. This car creates a strong bond between them. Both brothers owned the car and left a part of them attached to the car.Henry then goes off to war, and hands his keys to Lyman, but the car is abandoned just like the brothers relationship. The war has broken the attachment between the brothers. From this point, the boys try to give full ownership of the car to the other brother, realizing that neither of the brothers can own the entire red convertible for himself, because they both have part of themselves sentimentally attached to it. When Henry drowns, Lyman is compelled to drive the car in the river, destroying the part of the car that was Henrys.Without Henry, half of the car is symbolically miss ing and Lyman knows he cannot ever drive the car again because car was only driven when the boys were attached. The Oldsmobile could also be seen as a symbol of brotherhood and the war-torn relationships of soldiers when they return home. When they bought the car, they did not need to discuss it because they understood each other without saying a word. They travel together, and this represents a normal, healthy brotherly relationship. When Henry returned a changed man, he was not interested in anything, including Lyman and the car.Lyman understood and caught on that his brother did not care for life anymore because the car was life to him before the war and now Henry doesnââ¬â¢t care for it. When Lyman destroys the car in an attempt to get Henry interested, it is his gesture of brotherly love and also a demonstration of the separation between them. The car portrays the destroyed relationship between Henry and Lyman. And in response, Henry repairs the car, putting the last of his soul into the car. He remembers the condition the car and himself was in before the war and is concerned. Eventually Henry realizes he could not fix himself.This reflects the concerns that many soldiers had coming home regarding the futures of their relationships and how they feared it would just be another casualty of the war, which many were, including Henry and Lymanââ¬â¢s. He uses the fixed convertible to save his love for his brother. Later when Henry tells Lyman to take care of the car, both brothers understood that Henry was preparing for death. He could not leave the world with the car and his relationship with his brother broken, and fixes the car as his last shot to save both. When the car was finished and He and Lyman went on one more trip, he was ready to die.Lyman saw the car more as an instrument to try and return his brother to the way he used to be before the war. But once Henry drowns and dies, the car is useless to him. There is symbolism in the short story that reflects Native American culture in the modern world. Lyman and Henry go on trips for months, travelling the country. These trips could represent the nomadic lifestyle of early Native Americans. At the end of the story, before Henry drowns himself, he and Lyman share a moment of fun and laughter. Henry does a wild and crazy dance, and this could be reflected as a ritual or traditional dance of Native Americans.The color red is a big symbol in the story. The convertible is red and was specifically put in the title and story by Louise Erdrich. Red has a positive and negative meaning. Positively, red means strength and love. This reflects Henry and Lyman because their brotherhood bond was strong and powerful, and they loved each other. Red could also mean aggression and war. This obviously reflects the war that damaged the relationship between the brothers and ruined Henry, and also the anger the brothers had that the relationship and their lives were not the same and would never be t he same again.The color red shows up more in the story, like in the beginning when the two travels to the Blood Reservation and meet a girl named Susy. Blood is obviously red, and Susy represents a part of their lives that was happy and carefree, and would never be the same. She impacted the boyââ¬â¢s lives and the free-spirit they once had. The color red appears once more on the boyââ¬â¢s very last trip when they head east to Red Rock. This is where Henry accepts death and that his life will never be the same again and commits suicide. In literature,à symbolismà is used to give meaning to the writing beyond what is actually written on the page.The plot and actions that take place can be thought of as one level, while the symbolism is on another, deeper level to enhance the story. In her short story, ââ¬Å"The Red Convertible,â⬠Louise Erdrich uses symbolism to help the reader see the message and theme of the story. She takes the color red, the convertible, and other moments in the story and has hidden symbols and meanings in them that emphasize the theme of strong brotherhood between Lyman and Henry and the negative aftermath that war has on its soldiers relationships back home.
Friday, January 10, 2020
A Clockwork Orange: A Psychological Analysis Essay
The major theme of the movie can be interpreted as a major revulsion of psychological behaviorism as developed by B. F. Skinner and John Watson. Behaviorism states that behavior is a continuous learning process reinforced by reward systems. It also states that personality is nothing but a reflection of behavior, since the latter defines the former. In the movie, there were several attempts to reject the idea of behaviorism. Here are as follows: 1) At some point in the movie, Alex and his friends attempted to use ââ¬Å"narcotic mixed milkâ⬠in order to improve their ââ¬Å"violence instinct; 2) Alex sexual violence in the movie was deliberate and out of consciousness. It was the case when Alex wounded the ââ¬Å"cat ladyâ⬠after a sexual orgasm; 3) When Alex was in jail, he developed the so-called ââ¬Å"Ludovico techniqueâ⬠, a method of rehabilitating criminals. When the minister of the interior requested the jail for potential candidates for the treatment, Alex volunteered. During the treatment, he consciously attempted to stop it by showing that the treatment already cured him (in fact, he knew the loopholes of the treatment); 4) And, after some psychological tests in the prison, he realized that he was never criminally repulsive. He began to like Beethovenââ¬â¢s Ninth Symphony. Alex realized that he has no aversion with the music. In fact, he realized that the treatment itself never changed his behavioral outlook, since it was deliberate. The Ludovico technique is a method which uses operant conditioning (which was implied in the movie) (reinforcer). The purpose of the technique was to put the ââ¬Å"patientâ⬠in a condition to which he/she has aversion. In this way, the ââ¬Å"patientâ⬠would avoid such circumstance. A repeated application of the technique to the same patient would therefore be therapeutic. The main character though has a means to reinforce his violent behavior (reinforcement). Alex knew the problems of his technique and constructed loopholes to avoid it. In a sense, Alex became the primary reinforcer. He controlled the patterns of his own behavior by systematic analysis of the consequences of his behavior. Moreover, Alex knew that the Ludovico technique would never alter his actions precisely because he reinforced his own behavior. Now, what is the probability that Alex criminal behavior may occur again after reinforcement? The answer lies on the concept of operant response. In the case of Alex, the probability is close to 1. Alex knew that the technique would never change his behavior. In fact, he created the technique in order to ââ¬Å"retainâ⬠his behavior. Moreover, because the technique proved ineffective in Alexââ¬â¢s case, then one may assume that Alexââ¬â¢s behavior did not really change. His response to the technique was deliberate and orchestrated. It is possible to say that the Ludovico technique failed to change Alexââ¬â¢s behavior because of faulty interval schedules. Interval schedules require a minimum period of time that must pass between consecutive reinforced responses. The interval should neither be too short nor too long. If the interval is short, then the ââ¬Å"patientâ⬠may become entrenched with his/her behavior (nothing will change). If the interval is long, then the ââ¬Å"patientâ⬠will be used to the technique (and therefore can possibly resist the technique). In the case of Alex, the interval schedule is close to short. It is possible that Alex may have been entrenched in his violent behavior because of the short interval schedule. Reference A Clockwork Orange. 1971. Directed by Stanley Kubrick.
Thursday, January 2, 2020
What Criteria Could You Differentiate Among Multiple...
Questions 1. How would you differentiate among multiple discriminant analysis, regression analysis, logistic regression analysis, and analysis of variance? The main difference is in the number of independent and dependent variables and the way in which these variables are measured. Note the following definitions: In Multiple discriminant analysis (MDA), the predictor or independent variables are metric and the single criterion or dependent variable is non metric . In Regression Analysis , both the multiple independent variables and the single dependent variable are metric. In Analysis of Variance (ANOVA) , the single independent variable is non metric and the multiple dependent variables are metric. 2. What criteria could you use inâ⬠¦show more contentâ⬠¦The result is an upward bias in statistical significance that must be identified during the analysis and interpretation. 4. How would you determine the optimum cutting score? For equal group sizes, the optimum cutting score is defined by ZA + ZB ZCE = ---------- N ZCE is the critical cutting score value for equal size groups, ZA is the centroid for group A and ZB is the centroid for Group B and N is the total sample size. For unequal group sizes, the optimum cutting score is defined by NAZA + NBZB ZCU = ------------ NA + NB ZCU = is the critical cutting score value for unequal size groups, NA is the sample size for group A and NB is the sample size for Group B 5. How would you determine whether the classification accuracy of the discriminant function is sufficiently high relative to chance classification? There has to be some chance criterion that should be established. This is generally a fairly straight-forward function of the classifications that is used in the model and of the sample size. The authors then suggest the criterion that the classification accuracy or the hit ratio must be at least twenty five percent greater than by chance. Other test can be to use a test of proportions to examine for the significance between the obtained hit-ratio proportion and the chance criterion proportion . 6. How does a two-group discriminant analysis differ from a three-groupShow MoreRelatedMarketing and Positioning Eureka Facts3041 Words à |à 13 Pagespreferences are found, or when the organization chooses to proactively build a stronghold by creating value preferences among a set of consumers. Segmentation as a process consists of segment identification, segment selection and the creation of marketing mixes for target segments. 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Construct ValidityRead MoreInfluencing Factors for the Selection of Mobile Phone Service Providers9769 Words à |à 40 Pagesselecting an operatorââ¬â¢s services. This research has applied exploratory factor analysis, confirmatory factor analysis and structural equation modeling for testing hypotheses. From the result it is revealed price or call rate is the most important factor followed by service quality, service availability and promotion. It is hoped that the findings of this study will assist the mobile phone industry of Malaysia in what they can produce in their services and how they want to promote their services asRead MoreSummary by Uma Sekaran7151 Words à |à 29 PagesCHAPTER I WHAT IS RESEARCH Research: is simply the process of finding solutions to a problem after a thorough study and analysis of the situational factors. Business research: systematic and organized effort to investigate a specific problem encountered in the work setting, that needs a solution. It comprises a series of steps designed and executed, with the goal of finding answers to the issues that are of concern to the manager in the work environment. Business research: organized, systematicRead MoreStrategic Management Process12814 Words à |à 52 Pageseconomic environment., or a new social, financial, or political environment.â⬠(Lamb, 1984:ix) Strategic management is a combination of three main processes which are as follows Strategy formulation â⬠¢ Performing a situation analysis, self-evaluation and competitor analysis: both internal and external; both micro-environmental and macro-environmental. â⬠¢ Concurrent with this assessment, objectives are set. These objectives should be parallel to a timeline; some are in the short-term and others onRead MoreMobile Banking11695 Words à |à 47 Pageson building mobile banking systems, but the adoption rate of mobile banking is still underused than expected. Therefore, research to enrich current knowledge about what affects individuals to use mobile banking is required. Consequently, this study employs the Unified Theory of Acceptance and Use of Technology (UTAUT) to investigate what impacts people to adopt mobile banking. Through sampling 441 respondents, this study empirically concluded that individual intention to adopt mobile banking was significantlyRead MoreBrand Building Blocks96400 Words à |à 386 Pagesmotivation to build brands. The second reason, the proliferation of competitors, reduces the positioning options available and makes implementation less effective. The third and fourth reasons, the fragmentation in media and markets and the involvement of multiple brands and products, describe the context of building brands today, a context that involves a growing level of complexity. The remaining reasons reflect internal pressures that inhibit brand building. The fifth reason, the temptation to changeRead MoreAn Examination of Selected Marketing Mix Elements13572 Words à |à 55 PagesBrand Equity and Its Dimensionality We test hypotheses in a field survey of existing brands in three product categories. In the next section, we present a conceptual framework of brand equity. We then review literature relevant to the relationships among the constructs and propose the research hypotheses. After describing the research method and reporting the results, we discuss implications of the findings and directions for future research. CONCEPTUAL FRAMEWORK Figure 1 exhibits our conceptual framework
Wednesday, December 25, 2019
Competency Managing Stress And Stress Management
Entry #1 Competency: Managing Stress Developmental Need: I need to improve on my ability to manage my stress. Often, I find myself feeling anxious about working with others, especially within group projects where I am not familiar with the work style of my teammates. As such, encounter stressors negatively affect my ability to focus on the task at hand. For example, I grew increasingly worried about the cohesiveness of my group because we needed to collect materials, figure out times to meet and film the project. When stressed, I tend to act moody around others and panic over the amount of work I have rather than managing my time effectively, which negatively affects my ability to work with others and accomplish tasks. Course Material: After reviewing the stress cycle and stress management practices, I chose to implement the stressor-directed primary prevention technique. Further reflection on the situation helped me understand that my main time stressor is work overload. Application: In order to manage my stress levels, I implemented both emotional and task-focused coping. To start, I used constructive self-talk and trained myself using the capacities of psychological capital. I specifically focused on confidence, despite knowing I am capable of being an effective and useful group member in group projects, I often worry about other team membersââ¬â¢ competencies. I used mastery/success experiences to think about the times I have been in groups where we were successful in ourShow MoreRelatedArticle Line Management Competence : The Key For Preventing And Reducing Stress At Work960 Words à |à 4 PagesLewis, 2008), the article Line management competence: The key to preventing and reducing stress at work. Strategic HR Review, 7(2) states, ââ¬Å"In the UK, Health and Safety Executive (HSE), was concerned about their employees. The company accordingâ⬠, (Donaldson et al., 2008), believed that work-related issues was due to stress. HSE has establi shed Management Standards for stress at work that are designed to help employers tackle the major sources of work-related stress risk (Donaldson et al., 2008)Read MoreNotes On Competencies Development Plan987 Words à |à 4 Pages743744 Competencies Development Plan Introduction: This assessment provides a descriptive feedback on the skills development activities I am planning to undertake during the length of this course in order to develop my key management competencies. With the help of the reflection activity undertaken in this assessment, I have been able to self analyse my managerial skills and prepare a plan for further building these competencies. Section A: Competency Assessment Graph 1 Graph 2 Stress ManagementRead MoreToo Many U.S. Expatriate Managers Fail Essay659 Words à |à 3 Pagesexpatriate managers end up quickly or they are found to be ineffective by their seniors. The major factors contributing to the failure of U.S expatriate managers include family stress, emotional immaturity, cultural inflexibility, over work and physical breakdown. Letââ¬â¢s discuss the reasons of family stress and cultural inflexibility. Stress experienced within family has been perceived as a factor that leads to the failure of an expatriate manager. It takes a bit of time for managers and their families to adjustRead MoreProblem Solving And Troubleshooting Domain1308 Words à |à 6 Pagesif it is realistic to expect to have a handle on stress management within a short time frame. Stress and anxiety is always something I have struggled with. I set high expectations for myself which leads to stress as I strive to satisfy my own expectations. I think referencing the concepts in Seven Languages can help me in this area as I believe I need to improve my self-talk. I also think I need to make time for things that help me to relieve stress. This is something I tried to be very consciousRead MoreLeading Org Final Exam Notes Essay1575 Words à |à 7 Pages1. Stress and well being Define stress and describe the stress experience Stress is an adaptive response to a situation that is perceived as challenging or threating to the personââ¬â¢s well-being. Distress ââ¬â negative destructive effects, can be caused from boredom or under stimulation or overstimulation. Eustress ââ¬âpositive, constructive effects which are better performance, etc. Identify the different types of stressors in the workplace Interpersonal Stressors, most common, include team dynamicsRead MoreThe Affects of Workplace Change and Stress1597 Words à |à 7 Pagesinevitability and stress as a byproduct. The tactics individuals and leaders adopt can cause harmful consequences if not managed with sensitivity and awareness. Change can be threatening for those experiencing job insecurity (Robbins Judge, 2007) or develop teams and co-workers that act at cross-purposes (Huy Mintzbereg, 2003). Change can be a source of stress, but so can workload, leadership styles, and the shuffling of roles and responsibilities (Cooper, 2006). Management of resistance and stress is largelyRead MoreOffice Space Movie Review1150 Words à |à 5 PagesOffice Space: Emotional Competency Analysis In Partial Fulfillment of the Requirements for the Course Communication 478-1: Organizational Communication By: Samson Mengesha Date: Nov. 25/ 2011 Office space, a critically acclaimed film, portrays many significant themes one faces in an organization. Although it may seem like this movie was a comically based office story, it tells a deeper story about one, Peter Giffins and his environment in the work place as he goes to work every dayRead MoreThe Importance Of Supervising A Supervisory Position1671 Words à |à 7 Pagesmore well-rounded supervisor in the future. Managing While I am not currently in a role in which I manage others, I could see myself in a management role in the future. I learned quite a few of the skills listed under the managing domain when I was with my previous organization. However, I feel like a few of the skills have to be learned again due to different business practices. In looking at the list of competencies and thinking of the competencies that those in leadership positions exhibit inRead MoreAn Assessment Of Competencies Of Team Leaders9717 Words à |à 39 Pagesââ¬Å"An assessment of the competencies of Team Leaders in managing work-related stress in the workplaceâ⬠By Jerrod Jarvis A Research paper presented to the Department of Occupational Safety and Health Cipriani College of Labour and Co-operative Studies In partial fulfilment of the Bachelor Degree in Occupational Safety, Health and the Environment Churchill-Roosevelt Highway Valsayn Republic of Trinidad and Tobago June 2015 ââ¬ËExcept where stated otherwise this report is based entirely on the authorââ¬â¢sRead MoreDiscrimination and Mission Statement Essay654 Words à |à 3 PagesInventory shrinkages and accidents pertain to which component of directà costs associated with mismanaged organizational stress? à 3) Which of the following is an example of an indirect cost associated withà mismanaged organizational stress?à 4) Distrust, disrespect, and animosity pertain to which component of indirectà costs associated with mismanaged organizational stress? à 5) Title VII is most relevant to the employment context because it __________onà the basis of race, color, religion
Monday, December 16, 2019
What the In-Crowd Wont Tell You About English Short Essay Topics
What the In-Crowd Won't Tell You About English Short Essay Topics Now you have a notion about what a proposal essay is and the way to pick the correct topic to compose your own essay, below are some examples of proposal essay topics. Try to remember, proposal essays serve a purpose outside academia. When you compose the essay, you will have to choose a single side to concentrate on. In other words, a proposal essay identifies an issue and suggests a remedy to that issue. Use transition words to get your text coherent and simple to read. Be mindful of the size it must be and begin writing the narrative essay outline. To structure an essay, you have to simply follow the aforementioned format. Firstly, you have to be aware of the right format of essay writing. When prior brainstorming is finished, you might begin drafting your essay. As tempting as it might appear to skip past the extra info and go right to the list of persuasive essay topics, don't do it. The multiple topics could be found, for instance, in the dissertation abstracts international database. There are broadly four kinds of essays. Short essays are still spend the type of formal essay because the parts will need to get included in it. Formal essays are usually academic in nature and tackle significant topics. Because proposal essays are a form of argumentative essay, you wish to be certain the essay is worthy of an argument. Finding the most suitable arguments will allow you to prove your point and win. There are a couple of explanations for the immense expansion in words. A fantastic persuasive topic also needs to be interesting, relevant and ought to deal with contemporary troubles. An excellent persuasive speech topic ought to be specific and focused. The Essay Topics list is provided for English along with Hindi section. Deciding on your topic isn't that easy. Essays are extremely personalized. They are like stories, only that they are a bit formal. There are certain kinds of essays we've given as samples to help students acquaint themselves and learn to compose various samples. By doing this it is possible to easily finish the descriptive paper. Well, grading papers can be very dull. Whatever it is that you want to focus on polishing on, then you'll find available English study materials. A wide selection of globalization essay is provided above to help students getting education in many classes. Proposal essays are typical in company and science classes and professions, but are also practical for a range of unique disciplines. You need to understand how to compose an effective essay as it is a typical foundation for a student's grade. If you are searching for assistance with your essay then we provide a comprehensive writing service given by fully qualified academics in your area of study. The simplest way to find out the sort of an essay is to realize the writer's point of view. Hopefully, you could find a couple of tips that you believe can help you improve your essay writing abilities. You may continue to keep your argumentative essays for your upcoming job portfolio in case they're highly graded. Additionally, by arguing for the other side of your opinion, you are going to learn which points you want to better address in your essay. Moreover, our English-speaking writers make sure every order has original content and a suitable structure. To compose an impressive short essay, especially during an examination, you should be in a position to hit the question and supply a straightforward answer while at the identical time observing the most suitable structure of an essay. So, it's a significant foundation for assorted epic stories! For example, you may be writing an essay arguing that individuals should drink less coffee. Some individuals have short attention span so that you want to have the writing skills to get your point with merely a few words. Opt for a distinctive topic that others may not think of, and whatever you select, make sure that you know a lot about it! If you wish to write in another language, you have to practice in creative ways each day.
Sunday, December 8, 2019
Down Syndrome free essay sample
Peer Partner Final Project Down syndrome is a chromosomal condition in which an individual possesses extra genetic material, specifically an extra complete or partial duplicate of chromosome 21 in some or all of an individuals cells. This results in several hallmark characteristics and acute cognitive affects. Some of the physical traits associated with the syndrome are a small body, especially head and ears, hypotonia, hands that are broad and short, epicanthal folds, abnormalities of the ear, and nasal bridges that are flat in shape. There are also several orofacial characteristics such as a protruding tongue that occurs as a secondary characteristic to having a small and narrow palate (Saenz). These are just some of the physical characteristics commonly seen in the chromosomal condition, but the actual presentation of physical characteristics is highly individualized. Down Syndrome is the most common chromosomal condition, affecting one in every 691 babies born in the United States and over 400,000 individuals live with the chromosomal condition in the United States (ââ¬Å"Ear, Nose and Throat and Down Syndromeâ⬠, Fogle 281). There is a slightly higher incidence of Down Syndrome in boys than girls. Infants are often diagnosed at birth by the occurrence of physical characteristics, but the actual expression of Down Syndrome varies considerably, and the diagnosis may be delayed if too much importance is put on only the typical physical characteristics. The diagnosis will be later confirmed through the use of ââ¬Å"genetic karyotypingâ⬠, which determines the number of chromosomes present in the bodys eukaryotic cells (Saenz 381). The first physical characteristic of the chromosomal condition that is noticeable is often the presentation of hypotonia, the prescence of which should inspire concern and spur subsequent and swift assessment. Down Syndrome is, in most cases, not an inherited condition. Down Syndrome may be caused by Trisomy 21, which refers to the condition of having a an extra copy of chromosone 21, meaning three copies, instead of two, in each cell. In these cases, the ââ¬Å"chromosomal abnormality occurs as a random event during the formation of reproductive cellsâ⬠(Down Syndromeâ⬠). This occurrence is possible in either egg cells or sperm cells, but it is most likely to occur in egg cells, and it is the occurrence of nondisjunction, a mistake in the division of a cell, that causes a reproductive cell to contain an odd number of chromosomes (ââ¬Å"Down Syndromeâ⬠). Likewise, Mosaic Down Syndrome is not an inherited condition. It happens in the early development stages of a fetus as a random occurrence in cell division, resulting in some cells having the normal duo of chromosome 21 copies, while some cells have three copies. In the third case, Translocation Down Syndrome, the condition may be inherited. A balanced translocation refers to the genetic material in between chromosome 21 and a different chromosome being in a different arrangement than normal that is called a ââ¬Å"balanced translocation because there is no extra material from chromosome 21â⬠(ââ¬Å"Down Syndromeâ⬠). The carriers of this balanced translocation do not display signs of Down Syndrome, but they have a higher risk of giving birth to children with the chromosomal condition. The syndromes severity ranges from the mild to moderate ranges; however, the one consistently present trait in children with Down Syndrome is mental retardation, and the syndrome is responsible for one percent of all cognitive mental retardation (Fogle 281). Despite these impairments many individuals are characterized as being generally pleasant, affectionate and happy people. While Down Syndrome individuals had a life expectancy of about 25 years in 1883, the life expectancy today is about 60 (ââ¬Å"Down Syndrome Fact Sheet ââ¬â National Down Syndrome Societyâ⬠). In respect to their receptive language, children diagnosed with Down Syndrome often have language comprehension that is about the same as their mental age. Note, that this is often different from their chronological age. As a general rule, their aptitude for language comprehension is greater than their aptitude for expressive language, specifically speech. It is important to note that these children frequently exhibit comparatively good development of language in their infancy and toddler stages, this is particularly true when the children are enrolled in early-intervention After this period of time, however, in the first school years the rate of language development noticeably slows down. In terms of general diagnostic testing, it is recommended by The American Academy of Pediatrics and the Down Syndrome Medical Interest Group that babies diagnosed with Down Syndrome should have audiologic testing directly after the are born and then again every six months until the child is three, or until they can sit for an audiogram with ear specific testing. After this point, there should be an annual hearing test, and even if there is only a mild hearing loss, hearing aids should be considered. This is because a mild hearing loss in a child is more severe that it would be in an adult because of the development of the childs intellectual, emotional and language based skills (ââ¬Å"Ear, Nose, and Throat and Down Syndrome ââ¬â National Down Syndrome Societyâ⬠). The tests should change with their development. Newborns who have been diagnosed with the syndrome receive the mandatory hearing screening and receive objective tests like otoacoustic emissions or auditory brainstem response like other babies. Those who fail the screening should be tested with visual reinforcement audiometry at the devlopmental age (not chronological age) of ten months and conditional play audiometry when they reach the developmental age of two years. Adults should have a hearing assessment conducted every five years, ideally with pure tone audiometry testing and an additional word test (Snashall, Susan). Due to differing craniofacial and orofacial anatomy, tymapnometry will always be a useful test for middle ear fluid. Likewise, an otoscopic exam should be conducted annually to check the accumulation of wax. The buildup of cerumen is so common that pathologies of the middle ear may go unnoticed unless searched for by otoscope. A study by Hassman E. , Skotnicka B. , Midro A. T. , and Musiatowicz M. was conducted in 1998 to examine features of hearing loss in individuals with Down Syndrome through otorhinolaryngological examinations and audiological assessments. The study involved forty seven children and fourteen adults with Down Syndrome. Tests were decided upon by the chronological age of the subjects, their intellectual abilities and the function of their middle ear; ââ¬Å"pure tone play audiometry, tympanometry, acoustic reflex, auditory brainstem response and distortion product otoacoustic emissionsâ⬠(Hassman E et. Al 199) were the examinations included in the study. The resulting data were compared to control groups of the appropriate age. The results showed that the children with Down Syndrome often exhibited impaired ââ¬Å"conductive function of the middle earà expressed by pathological tympanometryâ⬠(Hassman E et al. 199). More specifically, B and C type tympanometry was found in 56% of the individual ears that were tested. It was also found that distortion product otoacoustic emissions had lower amplitudes in the children diagnosed with Down Syndrome than those found in the control groups. In light of the time component in the development of language in children with Down Syndrome, hearing impairment is a significant problem, especially since hearingà impairment is ââ¬Å"one of the most common disabilities in children with Down Syndromeâ⬠(Kattan et al. 931). The ability to hear is essential to a childs ability to develop language and speech and because many children with Down Syndrome have hearing problems early in their lives, hearing loss is a great concern for these individuals. Consequently, children with Down Syndrome who are diagnosed with a hearing impairment are in danger of having learning impairments subsequent to their hearing loss. Therefore the diagnosis and treatment of otological disorders in children is an important topic for the education of speech and language students as well as clinical research. A study by Kattan, Jarrar, and Mahasinin 2000 found that 50% of the 26 children they tested had a conductive hearing loss, 4% had sensoirneural hearing loss, 4% exhibited a sensorineural hearing loss, while 35% had normal hearing (Kattan et al. 931). Though a small study, it supports the general consensus that children with Down Syndrome have a high incidence of persistent conductive hearing loss. This must be aggressively diagnosed and managed because this hearing loss may turn out to be one of the major factors that may cause the spoken communication abilities of Down syndrome children to rate significantly lower than their actual cognitive abilities. The conductive loss often seen in individuals with Down Syndrome can result from several otologic pathologies such as stenotic ear canals, otitis media, glue ear, cerumen impaction, and cholesteatoma (Satwant S. et al. ). Stenotic ear canals refer to an external ear canal, the canal that connects the external ear to the middle ear, that has become unusually narrow. If the ear canal is narrow enough it may cause a hearing loss. The stenotic ear canals can present several practical problems, the canals may become easily clogged, and it may be difficult to correctly diagnose middle ear disease in stenotic ear canals. To be sure of appropriate examination and diagnosis, the canals may require an otolaryngologist to clean the canals before examinations, which should occur every three months to prevent ear infections that may otherwise go undiagnosed and untreated. It should be noted that since ear canals grow with age, the childs canals may widen, and may no longer be a problem after about age three (ââ¬Å"Ear, Nose, and Throat and Down syndrome ââ¬â National Down Syndrome Societyâ⬠). The diagnosis for this is aided by a simple macroscopic examination of the canal or a standard otoscopic examination. In terms of treatment, a surgeon may remove extra tissue to widen the canal. Another concern is the actual craniofacial and orofacial anatomy of Down syndrome children which may also lead to chronic ear problems. Certain anatomical characteristics may impede the aeration of the middle ear which can lead to otitis media. The outer ear canal normally cleans itself, moving cerumen away from the tympanic membrane towards the external auditory meatus, but in children with Down syndrome, the canal is abnormally narrow making these processes less efficient and leading to a build up of ear wax. This accumulation of cerumen is made worse by the fact that it may be more copious and harder than normal, and the impacted ear wax may then block the external auditory meatus. There may also be problems with the Eustachian tube which connects the middle ear space to the nasopharynx. Eustachian tube dysfunction may result in otitis media with effusion (glue ear), which can result in a conductive hearing loss. Otitis media with effusion does not resolve on its own in Down syndrome individuals as it does in others due to the shape of the Eustachian tube. In general, the tube may be narrower and more horizontal than normal and the nasopharynx may be small (Snashall, Susan). Also, children with Down syndrome may have hypotonia, also known as low muscle tone, which may cause difficulties in opening and closing the tube. This can cause an accumulation of negative air pressure in the middle ear space which may result in retention of fluids and infection (ââ¬Å"Ear, Nose, and Throat and Down Syndromeâ⬠). Another concern about Eustachian tube dysfunction is that it will last longer in children with Down syndrome that other children, so an important part of prevention is frequent examinations and consistent monitoring. Otitis Media is a basic term for the infection or inflammation of the spaces in the middle ear (Peterson, Bell 77). Though otitis media is a very common childhood illness, children with Down syndrome are particularly susceptible to ear infection including serous otitis media (thin, watery fluid is present with infection). There are several causes for this; for one, individuals often produce large amounts of mucous. When this is coupled with immunodeficiency in the individual, infection may easily occur. Also due to immunodeficiency, children with Down syndrome have a higher incidence of upper respiratory infections which can predispose chronic (lasting at least six weeks) otitis media. Upper respiratory infections or allergies may result in a swollen Eustachian tube which may entrap bacteria and may result in otitis media. Symptoms of otitis media include ear otalgia, which refers to ear pain, fever, and otorrhea, which refers to discharge of the ear. To diagnose otitis media, an otoscopic examination will often be effective. The doctor will be looking to see a tympanic membrane that is normal in color, pink to gray, and it should be slightly translucent. An inflammed, red or engorged eardrum will point towards infection, as well as a tympanic membrane that bulges outward, retracts inward, or shows signs of perforation. Other options are tympanometry to test the middle ear function and test for fluid. If a child experiences chronic Eustachian tube dysfunction, treatment may include pressure equalization tubes which can eliminate the chronic episodes. These tubes are placed in the eardrum and allow air to enter the middle ear. The downside of the tubes is that they may need to be replaced. For chronic ear infections, anti-biotic medication may also be considered. Glue ear is also called secretory otitis media or otitis media with effusion. Like regular otitis media, it has a high incidence in Down syndrome children. A mucous like fluid secretes and gathers in the middle ear, which should only be filled with air, and covers the ossicles, preventing them from moving normally, which results in reduced hearing levels. While glue ear is common, Down syndrome provides extra complications to this condition. For one, the glue-like substance is stickier which makes it more difficult to wash and prone to infection. Again, anatomy may affect the condition because if the Eustachian tubes are narrower and more horizontal, it will be difficult for the Eustachian tube to let the middle ear drain. Treatment of glue ear is essential because, if left untreated, glue ear may result in irreversible damage to the middle ear, this may be due to the lack of motility of the ossicles. Fortunately, there are three main approaches to treating glue ear: pressure equalization tubes, microsuction, and tonsillectomy, adenoidectomy or both, so there are several options to accommodate individual needs. The procedure to inset pressure equalization tubes is called a myringotomy operation and refers to the small cut made in the tympanic membrane which may also be done as a separate procedure. It is generally performed with the patient under a general anesthetic. If the fluid is very viscous a cut will be made to let air into the middle ear space while the other cut drains the fluid. Pressure equalization tubes go through the tympanic membrane, relieving the often painful pressure of the fluid against the eardrum, and allow for the fluid in the middle ear to drain into the external auditory canal. The tube is held in place by the tension in the tympanic membrane. The pressure equalization tubes will be pushed out of the tympanic membrane after a few months to a year of having them in place, but if they are placed correctly they are extremely effective, allowing the fluid to leave the middle ear space. If an adenoidectomy is to be performed as well, it will probably be during the same surgery. Adenoidectomy removes the adenoids if they are enlarged. Removal may be beneficial because it is behind the adenoids that glue ear may reoccur after pressure equalization tube placement. Another option is microsuction, which involves inserting a needle through the tympanic membrane and using it to draw out the fluid. The upside to this procedure is that the fluid does not end up in the external auditory canal and have to be cleaned, which is especially helpful in children with Down syndrome with narrow canals. The downside of microsuction is that it often requires several procedures. Like glue ear, cerumen impaction is a very common otologic pathology, and it has a high incidence in individuals with Down syndrome. It is a common cause of conductive hearing loss. Ear wax is meant to protect the skin of the canal, especially when it is filled with water. Normally, the wax should move towards the opening of the ear it is easily washed away. As mentioned before, individuals with Down syndrome often have cerumen that is abnormally hard or thick and accumulates quickly in a narrow ear canal and may quickly block the canal with partial or full occlusion. This may result in a reversible conductive hearing loss. In ââ¬Å"a study of 107 children with Down syndrome who were referred to otolaryngologists showed that 39% had stenosis of the external auditory canal frequently complicated by cerumen impactionâ⬠(Roland et al. 52). The combination of the accumulation of thick cerumen and auditory canal stenosis can quickly lead to a conductive hearing loss. The symptoms of impacted cerumen are earaches, the sensation of plugged ears, tinnitus, and some hearing loss. To remove the ear wax, oil can be used to soften the cerumen. This may also be done as a preventative measure. Many cases of cerumen impaction may be treated at home, but in cases of auditory canal stenosis, the family may have an otolaryingologist remove the wax. Irrigation of the ear canal may also be effective, but irrigation should never be performed if the tympanic membrane may be perforated as this could lead to acoustic trauma or otitis media. Cholesteatoma are benign ear cysts, and, specifically, they are accumulations of squamous epithelium and karatin material that usually accumulate around the middle ear and mastoid and form a ââ¬Å"progressively enlarging and destructive cystic lesionâ⬠(Issacson 604). The cholesteatoma may continue to enlarge to the point where it will destroy bone. If untreated, lesions may break through the temporal bone and apply pressure to the brain, which may result in infection that may, in turn, lead to intercranial abscesses. Individuals with Down syndrome are more at risk for developing cholesteatoma because they may have some of the conditions that put individuals at risk for developing the cysts such as ââ¬Å"middle ear diseases, eustachian tube dysfunction, prior otological surgery, traumatic blast injury to ear, and congenital anomaliesâ⬠(ââ¬Å"Cholesteatomaâ⬠). If an individual complains of otorrhea (discharge from the ear) or hearing loss, an otolaryngologist should realize that cholesteatoma might be present (Bacciu et al. ). Cholesteatomas may cause irreversible hearing loss but fortunately, most incidences may be cured through surgery. The surgerys outcome depends on the size of the cholesteaoma when it is diagnosed. For children, it is important that lesions in the tympanic membrane are diagnosed by a pediatrician and that the child is then referred to an otolaryngologist. The cholesteatoma will be first noticeable as a round cyst, white in color, that can be seen behind the tympanic membrane, which is still in tact. If the cholesteatoma goes unnoticed, it will grow and the middle ear space will have a large white mass that bulges outward. A cholestatoma may be congenital or acquired. As they enlarge, the normal variegated appearance of the middle-ear space disappears, replaced by a bulging white mass. In the early stages of the cholesteatoma, it is unusual for the tympanic membrane to be perforated and for drainage to occur. These incidents most often come months or years after the onset of hearing loss which helps emphasize the importance of early detection (Issacson 607). A 2005 study by Bacciu, Pasanisi, Vincent, et al. , was conducted to ââ¬Å"document the surgical treatment of cholesteatoma in subjects with Down syndromeâ⬠(Bacciu et al. 1007). This study exemplified some of the methods used to treat cholesteatoma as well as the challenges inherent in the treatment of this otologic pathology for Down syndrome individuals. They followed nine pediatric patients that were being surgically treated, and two of the patients had cholesteatoma in both ears (bilateral), which brought the total of ears being treated to 11. Two of the ears underwent a canal-wall-up mastoidectomy, while eight ears underwent a canal-wall-down mastoidectomy. Mastoidectomy refers to the removal of an infected section of the mastoid bone. One ear underwent a modified Bondy procedure, a modification of the mastoidectomy which entails exteriorizing the mastoid cavity leaving the pars tensa and ossicles intact. The outcome of this study was that one of the ears that underwent the canal-wall-up mastoidectomy was found to have reamaining cholesteatoma present. Another ear, after the same procedure, developed recurrent cholesteatoma which necessitates a change to a canal-wall-down mastoidectomy. Another patients neotympanic membrane became perforated and had to be repaired. This study demonstrated that cholesteatoma can be difficult to completely eradicate in a patient with Down syndrome, and an emphasis should always be put on early diagnosis and prevention especially in light of the challenges presented by the orofacial and craniofacial anatomy of children with Down syndrome. Despite the fact that conductive hearing loss is more prevalent than sensorineural hearing loss in individuals with Down syndrome, they are more likely to more likely to ââ¬Å"have congenital permanent inner ear hearing loss than the general population (which has an incidence of 1:1000)â⬠(Snashall, Susan). One of the reasons this happens is because the Cochlear hair cells may be absent. If the hair cells are present, they may still be subject to early degeneration. Once they reach their teenage years and after, they have a good chance of cochlear degeneration occurring. Hearing aids are often looked at as a viable option for even mild loses and amplification plays an important role in treating hearing loss in children with Down syndrome because it is probable that even a mild loss will have a strong impact on the development of their language. This is a severe concern, so hearing aids are also often recommended for conductive hearing loses that may last for over a few months. Hearing aids are also used with Down syndrome adult individuals who are living with early onset dementia because the loss may significantly affect their cognition skills. There are special considerations to take into account when Down syndrome individuals are to receive hearing aids because their ears tend to be smaller. It may also be that hearing aids are not appropriate for a child and a classroom FM system may be implemented instead. For cases of sensorineural hearing loss, recruitment is nearly always concomitant with the loss. Recruitment refers to the perception that the level of sound drastically increases for specific frequencies and becomes too loud too quickly and causes pain. It follows, then, that recruitment may lead to sound intolerance. This concern will be reflected in the prescription for the amplification devices. Down syndrome is the most commonly occurring chromosomal condition, and research into improving the quality of life for people with Down syndrome is, of course, incredibly important. It may be easy to underestimate the impact that a hearing loss may have on an individuals quality of life, especially in children when even a mild loss can be devastating to their speech and language development, but hearing is a critical skill for communication which is an integral part of a good quality of life. Thus, the treatment of otologic pathologies and hearing loss in Down syndrome is of the greatest concern to giving individuals with Down syndrome the quality of life they deserve.
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