Berry Aneurysms Case Study Example | Topics and Well Written Essays - 2000 words

Berry Aneurysms - Case Study Example An aneurysm usually balloons and may rupture as the forces increase, which would lead to rupturing of the arterial wall and interior bleeding, a situation that is usually fatal and leads to death. Consequently, berry aneurysms results from rupture of arterial walls in the brain with fatal consequences that may cause brain death. The condition is usually caused by defects in the tunica media muscles and lack of enough support from the brain parenchyma, which creates unprecedented stress to the arterial walls causing rupture (Liebeskind, 2013). Therefore, cerebral aneurysm occur incases were the strength of the internal elastic membrane of the adventitia and the tunica media are compromised mainly resulting from abnormal arterial structure at arterial bifurcations, which results in rupture of the vessels at these sections due to blood pressure (Liebeskind, 2013). Causes of Berry Aneurysms Various conditions may lead to berry aneurysms, which include the following: Arterial malformations, aorta coarctation, inherited polycystic kidney diseases and other vascular problems. Others include sickle cell anemia, fungal infections, Marfan syndrome, hypertension among others (Liebeskind, 2013). However, not much is known about the actual causes of the aneurysms and the formation processes leading to ballooning and rupture, but smoking that leads to vascular changes and hypertension are major some of the major predisposing factors (Jonathan et al., 2006). The main characteristic of aneurysms is reduction in the tunica media leading to arterial structural defects.... the reduced membranes causes formation of balloon like structures at the branching parts of the arteries mainly at the lower part of the brain (Jonathan et al., 2006). Epidemiology Most berry aneurysms are small in that 60% to 80% of all cases may not rupture, meaning they pose much less danger to the patient (Connolly & Solomon, 2004). It is estimated that between 10 and 12 million adults in America have intracranial aneurysms, with berry aneurysms accounting for about 90% of all these cases (Liebeskind, 2013). Those over fifty years of age, females and cigarettes smokers are at a higher risk of the aneurysms (Vega et al., 2002). Consequently, as Vega et al noted, berry aneurysm are responsible for the highest cases of mortality and morbidity affecting about 90% of all intracranial aneurysms. However, more cases are being reported in younger patients and especially in cocaine, users or those with smaller arterial diameters (Nanda et al, 2000) Presentation Most aneurysms do not have any symptoms and they may not be reported until they rupture; hemorrhage through a fatal medical emergency remains the single most prevalent clinical presentation in most cases, accounting for about 58% of patients (Yamaura, Onno & Hirai, 2000). However, patients report acute headaches at the onset, which in some cases may also be associated with brief sessions of unconsciousness, vomiting, meningismus and nausea. These hemorrhages are also misdiagnosed as most patients have milder symptoms that indicate a warning leak before the aneurysm ruptures (Vega et al., 2002). Studies have reported rupture rates of between 1.4 to 1.9 %, though the rates are higher in aneurysms of more than 10mmm diameter. However, rupture has also been reported in cases where the aneurysms are less than 5 mm in

Professional Ethics in the Construction Industry

Professional Ethics in the Construction Industry Introduction The business news headlines of ethical meltdowns of global companies such as Enron, WorldCom, and Tyco, which now have become synonymous with greed, serve as a key reminder to the companies and individuals in business to practice ethical behaviour (Doran, 2004). One of the most frequently reported unethical practices in business is bribery, described as: â€Å"the offering of some good, service or money to an appropriate person for the purpose of securing a privileged and favourable consideration (or purchase) of ones product or corporate project† (Almeder and Humber, 1983, cited in Johnson, 1991: 327). Building professionals have gain integrity and respectability through professional bodies such as the Royal Institution of Chartered Surveyors (RICS), Malaysian Institute of Architects (PAM), The Institution of Engineers Malaysia (IEM), and Institution of Surveyors Malaysia (ISM), which reflects the professionals of construction industry. These professional standards and ethics are embodied in codes of practice, which define the roles and obligations professionals (Harris et al., 1995) and are the cornerstone of any ethics programme (Calhoun and Wolitzer, 2001). Ethics and Professionalism The Oxford English Dictionary defines ethics as the moral principles that govern or influence a persons conduct. Ethics, as defined by Doran (2004), is the discipline dealing with what is good and bad about moral duty and obligation; a set of accepted moral principles and values about what ought to be; a theory or system of moral principles governing the appropriate conduct for an individual or group; and a code of morality. Doran points out that â€Å"ethics is something that the industry needs to talk more about, agree on, and put into wider practice† (2004: 4). Hinman (1997) distinguishes morals and ethics by regarding morals as first order beliefs, and practices about what is good and bad which guide behaviour; while ethics as second order, reflective consideration of moral beliefs and practices. Martin (2000), defines professionalism as setting aside personal values, feelings, and benefits in order to fulfill the obligations inhered in professional roles. Ethical behaviour, in construction context, is determined by the level of trustworthiness and integrity with which organizations and individuals perform their business (Mason, 2009). In a survey by Vee Skitmore (2003), it was agreed by 93% of the respondents that â€Å"business ethics† should be driven or governed by â€Å"personal ethics†, where there is a need to maintain the balance of both the requirements of the client and the impact on the public. Greenhalgh (1997), describes the core of professionalism as the self-reliant control of a group of experts possessing honorific status. Ethics have a role to play in general business practice despite the term â€Å"business ethics† being called an oxymoron (Ferguson, 1994). The applicability of general concepts of ethics to business is now realized after the recent appearance of greater consensus on this issue. This has been explained on the grounds that business exists not solely to accommodate certain individuals, but also to serve the society and, conforms to collective and social needs (Cohen and Grace, 1998) and environment in general (Fleddermann, 1999). Put differently, the spirit of a ny literal profession cannot be attained without an ethics element (Bowie, 1991). Professional Ethics in Construction Industry Professional ethics as defined by Martin (2000), consists of moral requirements attached to a profession and imposed on its members, together with ethical dilemmas created when there is a conflict of interest or the requirements are too vague to give guidance. Bayles (1988) describes professional ethics as a system of behavioural norms. Such norms ensure that professional does not take advantage over the client due to the knowledge differential the application of customer protection through self-regulation. Construction professionals, for instance, engineers, architects, project managers, surveyors and contractors, have the fundamental right of professional conscience (Martins and Schinzinger, 1996, cited in Fleddermann, 1999, p.87). Another important feature of ethics in the construction industry is â€Å"personal ethics† often interpreted by construction professionals as just treating others with the same point of honesty that they would want to be treated (Badger and Gay, 1996). Yet, it has been suggested that professionals in general tend to believe that their responsibilities to the client far outweigh the public (Johnson, 1991). An Australian study by Vee Skitmore (2003), demonstrates that most organizations subscribed to a professional code of ethics (90%), and many (45%) had an ethical code of conduct in their employing organizations. Reeck (1982) notes that ethical codes provide guidance for professionals in determining proper action. A South African study based on the work done in Australia shows that a new suite of professional Acts promulgated in 2000 in South Africa had boosted the profile of ethics (Vee Skitmore, 2003). However, Henry (1995) cautions that ethical codes do not solve moral dilemmas but do help to raise the levels of awareness and so encourage ethical practice. Professional Misconduct and its Impact to the Construction Industry The renowned cases of corporate malfeasance such as Enron reflect the unethical business practices that resulted in companies rapidly lose their reputations; shareholders revolt, unemployment, besides causing the whole industries to come under suspicion (Doran, 2004). Dorans research has shown that unethical behaviour affects the publics perception of the industry (61%), and more significantly, it affects the level of trust between clients and contractors (74%), and between contractors and design professionals (60%). As a matter of fact, codes of practice alone are insufficient to ensure ethical conduct in the construction industry. Ethical misconducts continue to happen in the construction industry, for instance, collusive tendering that results in apparently competitive bids, price fixing, or market distribution strategies that prohibit the spirit of free competition and defraud clients (Zarkada-Fraser, 2000), bid-cutting (May et al., 2001), bid-shopping, cover pricing, hidden fees and commissions and compensation for unsuccessful tenderers (Ray et al., 1999; Zarkada-Fraser and Skitmore, 2000), together with â€Å"withdrawal† ( Zarkada, 1998: 36) where a tenderer withdraws their bid after consultation with other tenderers. Other frequently reported unethical practices are related to fraud, breach of confidence and negligence. Deceit, trickery, sharp practice, or breach of confidence, by which it is sought to gain some unfair or dishonest advantage, is the description of the unethical practice of fraud (Bolgna et al., 1996: 9). A common breach of confidentiality is whistle blowing, described as the act of an employee of informing the public or higher management of unethical or illegal behaviour by an employer or supervisor (Johnson, 1991: 32). Negligence is the â€Å"failure to exercise that degree of care which, in the circumstances, the law requires for the protection of those interests of other persons which may be injuriously affected by the need of such care†. (Delbridge et al., 2000). The main sources of negligence are design negligence, design defect, production defect or a combination of these factors (Thorpe and Middendorf, 1980: 75). Barriers that Limit Professional and Ethical Behaviour Brien (1998), states that the cause of ethical failure in an organization can often be traced to its organizational culture and also the failure of the leader to encourage ethical practices among the members. In spite of the fact that personal ethics that constitute to perception of beliefs, values, personality and background, any tendency of an individual towards ethical conduct is strongly influenced by the value systems reflected by the employing organization (Mason, 2009). According to one study by Pearl et al. (2007), the extent to which ethical internal control is exercised within an organization will influence the difficulty facing any professional community. When the participants of the construction industry get caught in a compromising situation, the temptation for them to be unethical can be almost irresistible which is particularly true at the contractor level. The pressure on contractors are emphasized by Stansbury (2005), Chairman of Transparency International (UK) that, the majority of contractors engaged in corruption are forced by the way the industry and the political environment operate. Furthermore, there is no consensus on precisely what constitutes unethical behaviour and what should be done to improve it (Mason, 2009). Improving Professional Ethics in the Construction Industry There are contravening opinions as to whether or not the adoption of ethical codes has enriched ethical standards in the construction industry. Indeed, some commentators have even suggested that an ethical code is nothing more than public relations â€Å"window dressing† (Starr, 1983). Mason (2009), in his research describes that a single-wide code can contribute to the development of ethical standards within the construction industry as â€Å"the first line of defense against corruption† (Uff, 2003). The Code was intended to apply to all professionals of construction industry regardless of their qualification or affiliation. The principles are set out as accepted behaviour benchmark and regroup into seven qualities as honesty, fairness, fair reward, reliability, integrity, objectivity and accountability. Even so, Mason indicates that the change for a better ethical standards of conduct in the industry can only be achieved by reducing the chances for construction partic ipants to consider it a need to draw advantage at someone elses expense. He points out that other measures such as longer term relationships and collaborative working in the industry also play an equally substantial role in ethical improvement. Mason (2009), suggests that one way to improve ethical standards is simply by enforcing the law where unethical conduct is also a breach of the criminal law. This can be illustrated by the enforcement activity in the UK by the Office of Fair Trading (OFT 2007). The OFT aim is to ensure a fair competition during tender bid stages, which regards collusion as a contravention of competition, and the OFT has continues to conduct investigation to battle corruption. Dorans research (2004) has implied that the construction industry should get more training on professional ethics, where 97% thought that ethics training should begin at the collegiate level. Despite the trend towards increased training in the construction industry continues to grow, the initiatives to offer training on ethics is seldom heard. Doran suggests that companies should adopt ethical codes before increasing the training on ethics so that training will be more goal-orientated. References: Bowie, N. (1991). Business ethics as an academic discipline, in Freeman, R.E. (Eds). Business Ethics: The State of the Art. Oxford University Press: New York. Brien, A. (1998). Professional ethics and the culture of trust.Journal of Business Studies, 17, pp.391-409. Doran, D. (2004),FMI/CMAA Survey of Construction Industry Ethical Practices, FMI Corporation, Raleigh, NC. Retrieved October 8, 2009 from www.acce-hq.org/documents/ethics_survey.pdf Fellows, R. (2003). Professionalism in Construction: Culture and Ethics. CIB TG23 International Conference, October 2009, Hong Kong. Ferguson, W.C. (1994). Building a solid ethical foundation in business.The Executive Speaker, 9(1), pp.33-39. Fleddermann, C.B. (1999), Engineering Ethics. Prentice-Hall: Englewood Cliffs, New Jersey. Greenhalgh, B. (1997).Practice Management for Land, Construction and Property Professionals. Chapman and Hall: New York. Hinman, L. M. (1997) Ethics: A Pluralistic Approach to Moral Theory, Harcourt Brace Jovanovich. Johnson, D.G. (1991), Ethical Issues in Engineering. Prentice Hall: Englewood Cliffs, New Jersey. Martin, M.W., Schinzinger, R. (1996), Ethics in Engineering, 3rd ed. McGraw-Hill: New York. Mason, J. (2009). Ethics in the construction industry: the prospects for a single professional code. International Journal of Law in the Built Environment, 10(3), 192-204. Retrieved October 5, 2009, doi: 10.1108/17561450911001252 Office of Fair Trading (2007). OFT makes ‘fast track offer in biggest error UK cartel investigation, Retrieved October 19, 2009, from www.oft.gov.uk/news/press/2007/49-07 Pearl, R., Bowen, P., Makanjee, N., Akintoye, A., Evans, K. (2007). Professional ethics in the South African construction industry a pilot study. Journal of Construction Management and Economics, 25(6), pp.631-648. Reeck, D. (1982). Ethics for Professioans: A Christian Perspective, Augsbury: Minneapolis. Stansbury, N. (2005).Construction Environment is Prone to Corruption, Retrieved October 18, 2009, from www.buildingtalk.com/news/tch/tch193.html Starr, W. (1983). Codes of ethics: towards a rule-utilitarian justification.Journal of Business Ethics, 2, pp.99-106. Uff, J. (2003).Duties at the Legal Fringe: Ethics in Construction Law, Fourth Michael Brown Foundation Lecture. Vee, C. and Skitmore, R.M. (2003) Professional Ethics in the Construction Industry, Engineering Construction and Architectural Management 10(2), 117-127. Retrieved August, 28, 2009, doi: 10.1108/09699980310466596

Intelligence is Key Essay examples -- Art, Celtic Literature

Celtic literature features a full complement of female characters that deserve recognition; from warriors and rulers, to helpmates and daughters. Female characters, like their male counterparts, often have actions motivated by passion. The Morrà ­gan and Macha, act out of anger, disrupting a hero or cursing generations to come. Others such as Fà ºamnach, act out of jealousy, causing a series of events to unfold. However, the women who incite or prompt action due to their intelligence or wit – Rhiannon, Emer, Medb, Nes, and Mac Daa Tho’s Wife – are arguably the most complex and fascinating. Rhiannon purposefully, and with thought, gains the attention of the King Pywll and uses him to avoid an unwanted marriage. Rhiannon appears to King Pywll and his retainers halfway through branch one of The Mabigoni, on three consecutive days, riding a horse that even-paced, no other horse can match. On the third day, Pwyll himself rides after her, only able to catch up after requesting her to stop. They begin conversing and, in a single exchange Rhiannon both declares love for Pwyll and announces her engagement to another. She temps him: â€Å"I have never desired any man, and that because of loving you†, then announces her unavailability (â€Å"Pwyll,† 45). Rhiannon essentially ensnares Pwyll, allying herself with him and ensuring he will turn against her current suitor, Gwawl son of Clud. However, Rhiannon leaves nothing to chance. This strong female character even directs Pwyll’s actions in attaining her hand, and advises him when he blunders. She sets the time and place for her retrieval: â€Å"A year from tonight, in the court of Hyfaidd Hen† (Ford, 45). When her former suitor arrives in the midst of celebration, Pywll rashly promises anything he wa... ...tices that: â€Å"Sleeplessness has come to Macc Da Thà ³Ã¢â‚¬â„¢s house/ He has need of advice but speaks to no one† (Gantz, 181). She suggests that her mind may comprehend what his cannot, and he tells her his blunder, that he promised the hound to two. She suggests that he â€Å"give the dog to both sides- [and] let them fight over it,† (Gantz, 181). This would prevent one party from picking up the hound, and then the other party arriving and attacking him in anger. Though her plan does not go as hoped, she does offer a solution, protecting her husband from blame (the two parties are too engrossed with each other). Celtic mythology features a full complement of women who play an important role. Rhiannon, Emer, Medb, Nes, and Mac Daa Tho’s Wife use their intelligence to help further themselves, to enable those they love, or to protect. They create kings, heroes and alliances.

How to Buy an Used Car Essay

First of all, when you find a car that you are interested in, you can ask a dealer or an owner about the VIN to learn more about it. The VIN, vehicle identification number, is a unique serial number for every modern car. Basically, it includes a car’s brand, model, years of car, engine type, and many other things. The first digit of the VIN shows the country number and the tenth digit is the year of the car. For example, if the tenth digit is 9, that car is made in 2009. You can also check the vehicle history report with the VIN. This shows how many people have owned a certain vehicle, accident records, and how many times that car has been maintained. This could be the most important for your decision making process, giving you complete peace of mind about the vehicle you are buying or saving you thousands of dollars in unexpected repair costs down the road. It is a good idea to look for another car if those cars have been transferred to others too many times or have been involved in major accidents. KBB (Kelley Blue Book) or CarFax are online companies that offer the most reliable information in the U. S. for checking the VIN. Another thing that you might look at before you buy a used car is the car’s body. It is wise to check out both the interior and exterior in detail. For instance, you can examine the windshield wipers, if the body panel colors match, if there are any scratches or dents, and many other things you can see. Sometimes you can’t find any records of accidents with the VIN if the owner fixed his or her car by himself or herself. When you have a chance to look at a used car, it’s a lot easier to do if the car is clean and dry. If it is dirty, you have to ask the owner to clean it, or you will probably miss something. If the vehicle is clean, you can look at the vehicle from different angles to check if everything looks smooth, straight, and if the paint texture of different panels match. You want to pay a lot of attention to the paint job. Repainting is usually done to remove minor scratches and small areas of cracked paint. It may be found a repair job after a bad accident involving damage. If you are unsure whether or not the car has been repainted, you can simply ask the seller about this problem. If the previous owner or dealer doesn’t give you the answer clearly, you can look for signs such as paint overspray inside door jambs, inside the gas filler cap, on exterior moldings, inside the wheel, on the bumpers, and any other place near the painting spot. However, repainting is not always a sign of previous damage. Some people have their cars repainted for cosmetic reasons, especially if it is an older model. You should not miss that the interior is just as important as the exterior. Take a look at the overall condition of the car. Usually, people will wash the car and vacuum inside of it before they sell it. Even if it is clean, you need to focus on every part that you can see. You might check if there is any water or if there are any oil stains inside. That means there must have been water leaking from the windows, sunroof, or anywhere on the car that is cracked due to rain. It doesn’t look like a big deal, but over time, it will harm a driver’s breathing due to exposure to mold. You also have to be sure all gauges are in the right place and are in working condition. If you notice any part missing, ask what was there and why it was removed. Then, you can turn the ignition to â€Å"ON† to inspect if all gauges and warning lights are operating properly. After inspecting the dashboard, you can check the accessories; the radio, speakers, tape deck or CD player, air conditioner, defroster, horn, mirror adjustment buttons, washer and wiper, all door and window locks, and any other functions you can see. Pay more attention when examining the windows. It is important to check if the windows slide all the way up and down easily because they do not work properly if there is damage inside the door. Finally, mechanical problems are the most important to check up on before you purchase a used vehicle. There are hundreds of things you have to look at, but it is not possible to check every detail within a short period of time and when you are lacking tools. Not every person has the technical capacity of a mechanic. So it is highly recommended to have a used car inspected by a mechanic before purchasing, but it would be costly to do this for every car you are interested in. If you don’t want to bother your mechanic or don’t want to spend money for vehicle inspection, you can do it yourself. The most important thing you have to know about inspecting mechanical issues is finding leaks. Leaking fluid or oil is the most common and worst problem for older models of cars. You can use a flash light to see under the hood and try to find any leak spots. Engine oil, coolant, refrigerant, brake fluid, and power steering fluid are some examples of fluids that may leak. You would also want to look at any other parts connected either rubber or metal hoses. Buying a used car is stressful. It’s like walking through a mine field. Some people are lucky to buy used cars for a good price without any problems and others have serious problems with their cars as soon as they get them. There are so many things to observe when you’re looking for used vehicles. It is hard to know where to begin.

Learning Disabilities Essay

Puzzling is the term teachers use to describe students with learning disabilities.   They tell us that these students look entirely normal, seem intelligent, carry on intelligent conversations – that they don’t appear to any different than other students. Yet these students have difficulty doing certain tasks – not all- in school.   Some have difficulty reading; others perform poorly in spelling; still others make frequent mistakes in math.   Teachers in many schools tell us that these students are very hard to teach – that they simply do not learn in the same ways or as easily as others their age.   They tell us that these students have special needs and are not easy to teach in large classes in which most other students perform reasonably well.   They tell us that modifying instruction so that these students can profit from teaching is an intricate process. Because of the heterogeneous nature of this group of children, the concept of specific learning disabilities has been hard to define or describe in few sentence or by a numerical score such as an IQ or by a decibel loss. Furthermore, because the field has been of interest to educators, psychologists, psychiatrists, neurophysiologists, pediatricians, ophthalmologists, optometrists, speech pathologists, and others, the problem has been viewed in each of those disciplines from different perspectives. Hence there is really the need for several definitions for learning disabilities and thus we can conclude that its definition is defined in â€Å"case to case† basis. Definition of Learning Disabilities Historically, the following terms were used to name children with Learning disabilities: ââ€"   perceptually handicapped ââ€"   brain injured ââ€"   neurologically impaired Then, there came two broad aspects of concern in defining and or identifying those children: biological etiology- â€Å"minimal brain dysfunction†, psychoneurological learning disorders. behavior – â€Å" developmental disparity in psychological processes†, developmental imbalance† The definition of learning disabilities in an educational term has derived its heritage from: ââ€"   neurology ââ€"   psychology ââ€"   speech pathology ââ€"   ophthalmology ââ€"  Ã‚   remedial reading      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Wiederholt (1984) has traced the history of Learning disability and has delineated three dimensions of disorders namely: (1) disorders of the spoken language studied primarily by neurologists and ophthalmologists such as; ââ€"   Samuel Kirk developed a test, the Illinois Test of Psycholinguistic Abilities, for use in describing language functioning and developing remedial programs. disorders of written language represented mostly by psychologists, speech pathologists, and educators such as; ââ€"   Grace Fernald established a clinic at UCLA where she perfected remedial reading and spelling techniques. disorders of perceptual and motor behaviors studied mostly by a number of disciplines such as; ââ€"   Goldstein, Werner and Strauss as pioneers of the field which listed the following behavioral characteristics that differentiated between those with and those without brain injuries: excessive motor activity, hyperactivity, awkwardness and consistently poor motor performance, erratic behavior, poor organization, high distractibility and faulty perceptions (like reversals) and ââ€"   Samuel Orton was a neurologist who believed that lack of cerebral dominance was a cause of language disorders. (In normal individual either the left or right side of the brain has dominance in controlling specific functions.) ââ€"  Ã‚  Ã‚   Cruickshank focused his efforts on the study of brain-injured children, specifically children with cerebral palsy. ââ€"   Getman, Marianne Frostig, Newell Kephart, and Ray Barsch focused on the correlation of perceptual disorders and developed remedial procedures ranging from optometric eye exercises, tracing and copying patterns, and differentiating figure from background in a puzzle, to making angels in the snow.      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Today, there are various provinces in Canada that have established programs for learning disabilities which was instituted for example by ââ€"   The Ontario Ministry of Education ââ€"   Saskatchewan Department of Education ââ€"   Halifax Board of Education and ââ€"   Quebec Ministry of Education But the most widely used definitions is the one incorporated by the Learning Disabilities Association of Canada or LDAC (2002) which state that, the term â€Å"Learning Disabilities refer to a number of disorders which may affect the acquisition, organization, retention, understanding or use of verbal or nonverbal information. These disorders affect learning in individuals who otherwise demonstrate at least average abilities essential for thinking and/or reasoning. As such, learning disabilities are distinct from global intellectual deficiency. Learning disabilities result from impairments in one or more processes related to perceiving, thinking, remembering or learning. These include, but are not limited to: language processing; phonological processing; visual spatial processing; processing speed; memory and attention; and executive functions (e.g. planning and decision-making)†. Further, LDAC mentioned that learning disabilities range in severity and may interfere with the acquisition and use of one or more of the following: oral language (e.g. listening, speaking, understanding); reading (e.g. decoding, phonetic knowledge, word recognition, comprehension); written language (e.g. spelling and written expression); and mathematics (e.g. computation, problem solving). Further, the U.S. Department of Education regulation further states that a student has a specific learning disability if: the student does not achieve at the proper age and ability levels in one or more of several specific areas when provided with appropriate learning experiences; the student has a severe discrepancy between achievement and intellectual ability in one or more of these seven areas: (a) oral expression, (b) listening comprehension, (c) written expression, (d) basic reading skill, (e) reading comprehension, (f) mathematics calculation, and (g) mathematics reasoning. To summarize, all these definitions of learning disabilities, it includes the following major concepts: The individual has a disorder in one or more of the basic psychological processes.   Ã‚  Ã‚   (These processes refer to intrinsic prerequisite abilities, such as memory, auditory   Ã‚  Ã‚  Ã‚   perception, visual perception, oral language, and thinking.) The individual has difficulty in learning, specifically, in speaking, listening, writing, reading (word-recognition skills and comprehension), and mathematics (calculation and reasoning.) The problem is not primarily due to other causes, such as visual or hearing impairments; motor handicaps; mental retardation; emotional disturbance; or economic, environmental, or cultural disadvantage. A severe discrepancy exists between the student’s apparent potential for learning and   Ã‚  Ã‚  Ã‚   his or her low level of achievement.   In other words, there is evidence of   Ã‚  Ã‚  Ã‚   underachievement.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The various definitions of learning disabilities have several elements in common: neurological dysfunction uneven growth pattern difficulty in academic and learning tasks discrepancy between potential and achievement exclusion of other causes Identification of Learning Disabilities In identifying individuals with learning disabilities, the following common characteristics must be observed: ââ€"   Disorders of attention: Hyperactivity, distractibility, poor concentration ability, short attention span; ââ€"   Poor motor abilities: Poor fine and gross motor coordination, general awkwardness and clumsiness, spatial problems; ââ€"   Perceptual and information processing problems: Difficulty in discrimination of auditory and visual stimuli, auditory and visual closure, and sequencing; ââ€"   Oral language difficulties: Problems in listening, speaking, vocabulary, and linguistic competencies; ââ€"   Failure to develop and mobilize cognitive strategies for learning: Lack of organization, active learning set, metacognitive functions; ââ€"   Reading difficulties: Problems in decoding, basic reading skills, and reading comprehension; ââ€"   Written language difficulties: Problems in spelling, handwriting, and written composition; ââ€"   Mathematics difficulties: Difficulty in quantitative thinking, arithmetic, time, space, and calculation facts; and ââ€"   Inappropriate social behavior: Problems in social skills deficits, emotional problems, and establishing social relationships. There are also other practical classification schemes that are useful: (1) the academic learning disabilities ( reading, arithmetic, handwriting, spelling, and written expression) (2) the developmental learning disabilities: ( attention, memory, perceptual skills, thinking skills, and oral language skills) A somewhat more systematic way to look at characteristics of students with learning disabilities is to look at those factors referenced in screening devices.   The following outline reflects the types of difficulties often observed in learning disabled students: (1) significantly different classroom behaviors difficulty in beginning or finishing tasks difficulty in organizing inconsistent in behavior difficulty in peer relationships (2) significantly below-average performance in auditory comprehension and listening difficulty in following directions difficulty in comprehending or following class discussions inability to retain information received aurally difficulty in understanding or comprehending word meanings (3) significantly below-average performance in spoken language use of incomplete sentences or unusual number of grammatical errors use of immature or improper vocabulary or very limited vocabulary difficulty in recalling words for use in self-expression difficulty relating isolated facts, scattered ideas difficulty in relating ideas in logical sequence (4) significant academic problems difficulty in reading fluency difficulty in associating numbers with symbols incorrect ordering of letters in spelling confusion of manuscript and cursive writing avoidance of reading confusion of math concepts – addition, multiplication (5) orientation difficulties poor time concept, no grasp of meaning of time difficulty in â€Å"navigating† around building or school grounds poor understanding of relationships (big, little, far, close, under, on, near) inability to learn directions (north, south, left, right) motor disabilities or significant underdevelopment for age poor coordination very poor balance awkward, poorly developed manipulative or manual dexterity lack of rhythm in movements III. Intervention for Learning Disabilities. This knowledge of the characteristics of learning disabled students is one basis for intervention. Thus, we have seen that children with learning disabilities compose quite a diverse group.   It should be no surprise then to find that the teaching and strategies approaches designed to help those children are also quite a diverse. But it is possible to cluster the various approaches into three broad educational strategies: task training, in which the emphasis is on the sequencing and simplication of the task to be learned. ââ€"   Ysseldyke and Salvia (1984) have advanced tow theoretical models namely: (a) analyzing the child’s abilities and disabilities and (b) analyzing the task and the direct training of the terminal behavior or task. This view is supported by behavioral analysts who advocate (1) finding out what the child can and cannot do in a particular skill, (2) determining whether or not the child has the behaviors needed to succeed in the task, (3) defining the goals in observable terms, and (4) organizing a systemic remedial program using reinforcement techniques. The applied behavior analysts do not infer processes or abilities that underlie difficulties but rely solely on the child’s interactional history and the current behavior and environmental situation.   They feel that their approach, which is task oriented and observable, is the most parsimonious approach, and to some it is the only approach needed. ability or process training, in which the focus is on the remediation and simplification of the task to be learned. Quay (1983) discussed the relative efficacy of ability or process training.   He stated that three approaches to remediation have evolved: (1) remediating a disability so that learning will be facilitated at a later date, (2) training and ability or process for its own sake, and (3) direct training of the task.   He concludes that the direct instruction method (task training) should be tried first and then discarded in favor of other methods if direct instruction is not successful. ability – or process-task training, in which the first two approaches are combined and integrated into one remedial program. Raschke and Young (1986) support this approach.   They compared the behavior – analysis model with the diagnostic-prescriptive model. They state that neither approach alone has the answer and propose what they call a dialectic-teaching approach into one system. Essentially the model assesses the abilities and disabilities of the children (intraindividual diffences), makes task analyses of the skills to be learned, and prescribes remediation in the functions and skills to be developed. This dialectic system they maintain â€Å"permits the teacher to assess, program, instruct, and evaluate the child’s psycholinguistic characteristics in the same system as his skill competencies and consequential variables†. Hence, the task of developing a definition of learning disabilities proved to be a formidable challenge.   Indeed, defining this population is considered such an overwhelming task that some have likened learning disabilities to Justice Potter Stewart’s comment on pornography: impossible to define, â€Å"but I know it when I see it.† Thus, defining learning disabilities in a way acceptable to all has continued as a debatable issue since the inception of the field.   Although a number of definitions have been generated and used over the years, each has been judged by some to have some shortcomings.  Ã‚   There are many types of disabilities, each of which may require a unique diagnosis and a unique remedial method. POSITION PAPER   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The definitions of learning disabilities are numerous and so varied that it is difficult to present taxonomy or even a specific list of these different definitions.   The definition of learning disabilities is a problem in much of the nations throughout the world. This problem first came out when some parents in the United States became concerned because their children who were not learning in school were rejected from special education since they were not mentally retarded, deaf or blind, or otherwise handicapped.   Their children were called by various names such as; neurologically handicapped, brain-injured, aphasodic, dyslexic, and perceptually handicapped. In spite of its current widespread use, the term learning disability is vulnerable to misunderstanding and misuse. The condition is difficult to define operationally since the designation learning disability is an umbrella term for a variety of deviations that are not included in traditional categories of exceptional children. Also it has been confused with general learning problems that are common to some degree in most children. In addition, it has been misused to include educational retardation, which is found in slow learning children and in children who have not learned because of poor teaching or absence from school. Another vulnerability of the term comes from the difficulty in drawing an explicit line between normal and abnormal.   Some allowances must be made for biological and psychological diversity, and considerable variation in abilities is accepted as normal. So, the question now is, â€Å"If there are objections to the term learning disabilities, why use it?   Why not use some other term? Well and good, if a better term can be found.   Other terms are either too specific or too broad.   Dyslexia for example, only refers to severe reading disability and it is not the only learning disability.   Brain injury has little or no educational relevance.   Perceptual handicaps exclude children with language disorders. Hence, the label learning disability has evolved to encompass the heterogeneous group of children not fitting neatly into the traditional categories of handicapped children. And that, substantial number of children show retardation in learning to talk, do not acquire other communication skill, do not develop normal visual or auditory perception, or great difficulty in learning to read, to spell, to write, or to make arithmetic calculations. Some of them even, are not receptive to language but are not deaf, some are not able to perceive visually but are not blind, and some cannot learn by ordinary of method of instruction but are not mentally retarded. Although such children are from a heterogeneous group and fail to learn for diverse reasons, they have one thing in common: they do not perform as well in school as they could. Discussing the problem and the difficulties of names for these children, Kirk (1963) explained that sometimes classification labels block our thinking. He further stated that it is better to state that a child has not learned to read than to say the child is dyslexic. So he advised that the name should be functional.   He suggested further that since the parents were interested in service to their children, it might be preferable to use a term related to teaching or learning and that the term learning disability might be preferable over the currently used terms such as cerebral function and brain injured. The term learning disabilities were agreed by these parents and they consider it more appropriate since it implied teaching and learning and since they were interested primarily in service for their children. So, one of the major problems of definition is that a learning disability is not as obvious or homogenous as blindness or deafness. There are many types of disabilities, each of which may require a unique diagnosis and a remedial method may vary differently from another condition also termed a learning disability. It is no wonder that many students, teachers, and parents have become confused about the term learning disability and the characteristics of children so labeled. This confusion appears to be international and is illustrated by the remarks of a teacher who, in testifying to a government committee studying the subject (Learning Difficulties in Children and Adults, 1986), stated:   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   I find myself asking the following questions:   What does the term â€Å"learning difficulty† mean?   Does the term â€Å"learning difficulty† mean the same as â€Å"learning disability†? How about the term â€Å"dysfunction†? What does the term â€Å"minimal brain dysfunction† mean? Do they all mean the same? Certainly, all these labels are not necessary, or are they? Does labeling a child with learning problems create more problems? It all becomes a bit confusing†¦The terminology changes often, varies from state to state and from country to country. Out of these definitions, came my own definition of learning disability: Learning disability describes a result rather than the cause of the learning disability.   Therefore, the conditions we call a learning disability is defined in terms of the student’s difficulties – what he can and cannot do in school – and focuses primarily on the academic performance.   So, one cannot be labeled as learning disabled if he has not yet started formal schooling as the label learning disabled indicates that a student is having unusual learning difficulties and involves speculations to possible causes, but it specifically indicates that the primary cause cannot be a condition such as mental retardation, hearing or visual impairment, and so on. Learning disabilities should be identified in the formal school context. Thus, preschoolers should not be labeled as learning disabled as growth rates are so unpredictable at young age,   In addition, very young children who appear to have problems may be identified under a noncategorical label, such as developmentally delayed.   For many children, learning disabilities first become apparent when they enter school and fail to acquire academic skills.   The failure often occurs in reading, but also happens in mathematics, writing, or other school subjects.   Among the behaviors frequently seen in the early elementary years are inability to attend and concentrate; poor motor skills, as evidenced in the awkward handling of a pencil and in poor writing; and difficulty in learning to read.  Ã‚  Ã‚  Ã‚   In the later elementary years, as the curriculum becomes more difficult, problems may emerge in other areas, such as social studies or science.   Emotional problems also become more of an impediment after several years of repeated failure, and students become more conscious of their poor achievement in comparison with that of their peers.   For some students, social problems and inability to make and keep friends increase in importance at this age level. A radical change in schooling occurs at the secondary level, and adolescents find that learning disabilities begin to take a greater toll.   The tougher demands of the junior and senior high school curriculum and teachers, the turmoil of adolescence, and the continued academic failure may combine to intensify the learning disability.   Adolescents are also concerned about life after completing school.   They may need counseling and guidance for college, career, and vocational decisions.   To worsen the situation, a few adolescents find themselves drawn into acts of juvenile delinquency.   Because adolescents tend to be overly sensitive, some emotional, social, and self-concept problems often accompany a learning disability at his age.   Most secondary schools now have programs for adolescents with learning disabilities. Many teachers in Canada suggested that we abolish the label learning disability, and merge it with the emotionally disturbed and the educable mentally retarded and only deal with the child from an instructional point of view by defining learning tasks so that they can be taught step by step.   I strongly opposed with this suggestion.   Though maybe it is possible for the child with severe learning disability, but this approach is not sufficient to mild learning disabilities students. This is one of the greatest sources of controversy about the identification issues. The question of how much academic and learning retardation is evidenced before an individual should be identified as learning disabled.   Aside from identifying children with learning disability, it is very important to judge the extent of a child’s learning disability as either mild or severe.   Determining the level of severity is helpful in placement and in planning teaching delivery.   I strongly suggest that students with mild learning disabilities should be given different remediation from those of students who have severe learning disabilities. At this point, it is very crucial to differentiate the two cases.   Mild learning disabilities describe the problems of many students.   Students with mild learning disabilities usually have a disability in just one or two areas of learning, and although they need supportive help and special teaching, they can probably get along – at least for part of the day – in the regular classroom. So, within the regular classroom, the regular teachers should often make changes in instruction that will benefit these students. On the other hand, students with sever learning disabilities pose a very different problem and they require quite different educational services.   These students are likely to lag significantly in several areas of learning and to have concomitant social, emotional, or behavioral problems.   They need the environment of a special classroom, should contact mainly with one teacher, and should be given special services for most of the day.   Because of the intensity of their problems, the special class should be given fewer students than the regular classroom.   I suggest the 1:3 teacher to student ratio is the best to maximize and hasten the remediation process.   However, students with severe learning disabilities can gradually be mainstreamed for special subjects or activities or placed in the resource room, or even back in the regular classroom as their progress permits.   Because of these definitions; teachers, guidance councilors, and other school personnel, play the biggest role in identifying, diagnosing, remediating or treating this kind of disability within the school context.   So any teaching/service delivery should best meet the requirements needed to serve properly learning disabled students within the regular classroom.   Hence, learning disabled students should be treated or given remediation within the given school context with the greatest help of the regular classroom teacher but the guidance of the learning disabilities specialist.   So, it is implied that each school should have a learning disabilities specialist. With this, a change in the administrative arrangements for the placement for instruction of children with learning disabilities is a must.  Ã‚   It is important to take note that in the past, the rapid growth of special education was in the direction of removing atypical children from the mainstream of regular classroom and placing them into special education programs. Even the regular education supported this movement which maybe because the responsibility of educating children with a variety of learning problems is transferred to the domain of special education, and that would really lighten the work load of regular teachers.  Ã‚   But that should not be the case and I do not support that movement. The trend should be reversed and all students with learning disabilities should be brought back into the regular classroom with the regular students and in the hands of the regular teacher with the help of the learning disabilities specialist.     Ã‚  A number of movements and researches support this claim. The influential movement that supports this claim is the REI or the regular education initiative led by Madeline Will, the director of special education in the U.S. Office of Special Education in 1986.   She stated that this initiative is designed to promote collaborative efforts among regular and special educators and â€Å"shared responsibility† (Will, 1986).   In this initiative, regular and special educators were encouraged to pool their talents and coordinate their efforts in planning and teaching.  Ã‚   I greatly support this initiative as the underlying premise of this concept is that student’s learning disabilities can be more successfully taught in the regular education classroom than in special education classes or resource room. By promoting the merging of special and regular education, the regular education initiative reflects a major change in the way students with learning disabilities are identified, assessed, and educated. The approach is supported by many special educators (Lloyd, Singh, & Repp, 1991; Maheady & Algozzine, 1991; Biklen & Zollers, 1986; Greer, 1988; Reynolds, Wang & Walberg, 1997).     Ã‚  A specific example is, more than fifty years ago, Samuel Kirk, in his presidential address to special educators, emphasized that all teachers (regular and special educators) have the responsibility for teaching learning disabled children.   Kirk implored that â€Å"every teacher †¦ is a teacher of learning disabled children† (Kirk, 1941).   He further wrote the following: Actually the education of exceptional children is not wholly the responsibility of any one group of teachers †¦. It is hoped that in the future all special class teachers will not only be responsible for the education of children in their classroom, but will take on the added responsibility of contributing their knowledge and special skill to the regular classroom teacher †¦ who (has0 many learning disabled children in (the) classroom. (Kirk, 1941) In 1968, Lloyd Dunn wrote an influential article about the benefits of having special educators work with regular teachers in serving learning disabled children (Dunn, 1968). Another view to change the administrative arrangement in special education is to group children with different disabilities together for instruction.   This categorical system in special education historically evolved as the field of special education developed.   Each category of disability (such as visual impairment, hearing impairment, mental retardation, orthopedic disabilities, speech disorders, emotional disturbance, and learning disabilities) became established individually over the years when there was sufficient interest in that particular area of exceptionality.   This concept emphasizes the common characteristics among students with disabilities and the common instructional methods for teaching students with various disabilities.   In this system, students with learning disabilities, behavior disorders, and mental retardation are often grouped together. Some parents and special educators are concerned that children with learning disabilities might be lost in the shuffle of this kind of placement, if such classes become a dumping ground for students with a variety of unrelated problems.   The resulting diversity of learning and behavior problems would impede teachers in helping students with learning disabilities. But this view is also opposed by a number of authors and has even provoked unusual levels of confusion, emotion, and debate within the special education community (Jehkins & Pious, 2001).   Moreover, other special educators and parents, express concern regarding the regular education initiative movement and caution that more study is needed before making full-scale and far-reaching changes in procedures and policies that will affect the lives of students with learning disabilities (Lloyd et al., 1991; Journal of Learning Disabilities, 1988; Cannon, 1988; Kaufman, Gerber, & Semmel, 1998; McKinney & Hocutt, 1988, Lerner, 1997). But these opposing views have no substance and should be disregarded altogether.   Fuchs & Fuchs (2000) have conducted research on the perceptions of and attitudes toward the regular education initiative among both regular and special educators.   These studies suggest that neither regular nor special education teachers are dissatisfied with the current special education delivery system.   In fact, the teachers favored the resource room model over the consultant model.   Many of the teachers saw no improvement in the achievement levels for either special or regular education students as a result of the regular education initiative reforms.   The success of the initiative depends on the support of regular and special teachers (Semmel, Abernathy, Butera, & Lesar, 1991; Coates, 1989).   Moreover, the research prove that merely shifting the responsibility from the resource room teacher to the regular or a consultant is not enough to ensure the success of the reform. Hence, major policy changes in regular education profoundly affect students with learning disabilities.   Several recent national study commissions on the poor quality of schools serving the learning disabled students.   It is my fear that, most school’s pursuit for academic excellence standards will left behind students with learning disabilities – or they will be the losers.   Being unable to meet the educational standards set by the pursuit-of-excellence movement, some students with learning disabilities will be denied a high school diploma and thus be denied the opportunity to complete their schooling.   Further, if regular teachers are held accountable for the academic excellence of their students, they will be reluctant to accept the responsibility for hard-to-teach students.   Some special educators predict that the push for excellence may serve to widen the schism between regular and special education (Pugach & Sapon-Shevin, 1997). Hence, it is my challenge to educators and healthcare professionals to undergo another education reform movement where school curriculum requirements for the learning disabled should be added to the current curriculum standards for the regular students. So in this recommendation for curriculum changes, a greater consideration should be given for the learning disabled students.   But this should be within the context of the regular education curriculum. This approach is same with the integration of regular and special education.   Some special educators also are now urging that the integration process should be taken much further – that the current special education system should be drastically restructured and that regular and special education should be merged into a single system (Kauffman & Trent, 1991).   Such educators cite several reasons for changing the current system.   Special education, they maintain, is not effective when it occurs outside of the regular classroom.   In addition, the physical separation of students with disabilities is demeaning and degrades instruction.   These special educators maintain that integrated special education is more effective than separate programs. So the delivery options for teaching students with learning disabilities should also include regular classes and resource room classes.   This approach is concomitant to the observation that successful adults with disabilities have learned to function comfortably in society as it exists – an unrestricted environment composed of all people.   To promote experiences in the greater society, it must be ensured that, to the extent appropriate, students with disabilities should have experiences in school with regular (or non-special education) students. Since society includes the family, parents too should not be forgotten as an important element in the entire complex.   Parents are a vital component in the student’s education. These parents of children with learning disabilities need help in accepting their situation.   Mental health professionals should help make parents be aware that the problem must be faced both by the child and by other members of the family.   In addition to an honest acceptance of the disability, there must be recognition that improvement is often a slow process. So any approach concerning children with learning disability should establish healthy parental attitudes and ensure parent-teacher cooperation is of course, very necessary.   Parent support groups and family counseling are effective in assisting parents understand their children and their problems and in finding ways to help their children within the home.   In addition, parent-teacher conference can become a bridge between the home and school and can involve parents in the educational process. Learning disabilities is now at a crossroads, as it seems to have been throughout its thirty-year history.   Many innovative ideas are only in their beginning stages and will develop more fully in the years to come. The approach I suggested as discussed in this paper is one of those ideas.   It is very important for this approach that more students with learning disabilities are served through regular education.   In addition, there should be more collaboration between special and regular educators.   A consequence of all of these shifts is that the responsibilities of learning disabilities teachers will change to meet the new demands. References Bush, W., and Giles, M.(1979).   Aids to Psycholinguistic Teaching. Columbus,   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Ohio: Charles E. Merrill. Clements, S. (1986). Minimal Brain Dysfunction in Children.   Public Health   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Service Publications. Department of Health, Education, and Welfare:   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Washington, D.C. 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