NRNP 6635 Week 1: Discussion – FACTORS THAT INFLUENCE THE DEVELOPMENT OF PSYCHOPATHOLOGY

NRNP 6635 Week 1: Discussion – FACTORS THAT INFLUENCE THE DEVELOPMENT OF PSYCHOPATHOLOGY

Functional Assessments and Cultural and Diversity Awareness in Health Assessment

Functional Assessments and Cultural and Diversity Awareness in Health Assessment

Socioeconomic, Spiritual, Lifestyle, and other Cultural Factors

The patient is an African-American man who is homeless, has experienced alcohol withdrawal seizures, has run out of medication, lives in a shelter, and needs to smoke to calm down and function. A socioeconomic issue affecting this patient is homelessness, which affects his consistent healthcare and a stable environment in which he can thrive. According to Bedmar et al. (2022), homelessness is a complex issue that affects beyond the lack of a place to live. It leads to poor health conditions and premature death because of the limited access to healthcare and resources for those affected. Homeless individuals are also at risk of developing communicable diseases and foot infections, which tend to have a low adherence to pharmacological treatments (Bedmar et al., 2022). There is also an increased risk of cardiovascular and neurological diseases, including diabetes, which are the most prevalent. Hepatitis and HIV positivity (Bedmar et al., 2022). Given this patient’s homelessness condition, it is evident that the patient in this scenario is already suffering from some of the consequences, such as low drug adherence, as he runs out of his medication. This patient lacks understanding of his medication and needs to follow up with his cardiologist to refill his prescription Functional Assessments and Cultural and Diversity Awareness in Health Assessment.

A spiritual issue affecting this patient could be a lack of support from a religious group such as a church, a mosque, or any other affiliation, leading him to turn to smoking as therapy to calm down. The patient is struggling with functioning and stress. Spiritual support could offer him a reprieve and reduce the need to use substances for stress management and as a coping mechanism.

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Lifestyle factors affecting this patient include substance use, medication adherence, and, likely, diet and exercise, given his hypertension. From the case information, the patient has a history of alcohol dependence that led to seizures from withdrawal. Additionally, drug adherence is difficult because of unstable living conditions. Lastly, limited access to healthy food, stress, and safe spaces for physical activity are likely to have limited the patient from observing a healthy diet and exercise, leading to his hypertension.

Culturally, African Americans tend to experience healthcare inequality and disparities, leading to reduced trust in the healthcare system. Worse, the patient is a homeless African American male, which exposes him to a higher risk of discrimination in the healthcare system, according to a study by Willison et al. (2023) that found that African Americans are four times more likely to be homeless and discriminated against in the healthcare system compared to their white counterparts.

Sensitive Issues

An issue that a healthcare provider should be sensitive to when handling this patient is judgment and stigma. The healthcare worker must avoid using judgmental language or words considered racial slurs or inappropriate. It is also important to empathize with the patient’s homelessness, addiction, and smoking habits. The goal is to ensure that the patient develops trust in the healthcare worker. Additionally, African Americans tend to experience discrimination in healthcare settings because of their race, according to Willison et al. (2023); therefore, it is necessary to ensure that this experience is not replicated in this patient’s case.

Another sensitive issue to consider when interacting with this patient is their privacy and dignity. The healthcare worker should ensure their discussions are private and confidential, remain respectful, and observe the patient’s dignity despite their socioeconomic status. Maintaining privacy and confidentiality is an ethical principle in healthcare that should be upheld regardless of a patient’s background, age, and condition.

Communication Techniques

A communication technique ideal when interacting with this patient is active listening, which entails paying close attention, being present, and asking questions for clarification (Kwame & Petrucka, 2021). Active listening is essential in this case because it encourages the patient to continue sharing important information that could be useful in their management, helps develop nurse-patient trust, and promotes patient-cantered care (Kwame & Petrucka, 2021). It is also essential to be empathetic during the interaction with the patient so that they can feel heard and develop trust towards the healthcare worker. Another ideal communication technique in this interaction is asking the patients open-ended questions, encouraging them to openly share their experiences without being judged. Using open-ended questions is essential in this case because it would encourage patient-centered care based on the information provided by the patient.

Health History Interview

1. What is your recent experience with alcohol withdrawal and other health issues you have been dealing with?

Asking this question would help the healthcare worker understand the severity and context of the alcohol withdrawal and seizures, as well as other health concerns.

2. How do you manage your blood pressure without medication? Do you have any other symptoms? Functional Assessments and Cultural and Diversity Awareness in Health Assessment

This question is essential in assessing the impact of operating without hypertensive medication to identify immediate health risks.

3. How do you feel about your current living situation, and do you have any support?

This question aims to gauge the patient’s emotional support system, crucial for his recovery and care.

4. How does your typical day look like? What substances are you using?

Asking this question helps to develop a comprehensive view of the patient’s lifestyle choices and how they affect their health. This information would be crucial in tailoring interventions for him.

5. Do you experience any barriers when accessing healthcare or medication?

This question establishes the specific obstacles preventing this patient from accessing consistent healthcare. The healthcare worker could have helpful information on how to circumvent these obstacles for the patient.

Risk Assessment Instrument

An appropriate risk assessment instrument to use on this patient is the alcohol use disorders identification test (AUDIT). This instrument is a 10-item tool developed by the World Health Organisation (WHO) (Brummer et al., 2023). It covers aspects such as drinking behaviors, frequency, and alcohol-related problems. The responses ranged from 0 to 4 in scoring, which made the highest possible score of 40. It is a valuable tool in identifying harmful drinking patterns and can help identify drinking as the cause of the illness presented to a patient (Brummer et al., 2023). It also provides a robust framework for risky drinkers to reduce their alcohol consumption and its impact.

            AUDIT would be ideal to use on this patient because the patient has a history of alcohol withdrawal seizures, which imply heavy alcohol use. It is, therefore, critical to assess his relapse risk and continued alcohol use using this risk assessment tool. Another reason for using AUDIT is that it is comprehensive in that it covers essential aspects of alcohol use, such as frequency, dependency, and effects. This information helps develop effective interventions for the patient.

References

Bedmar, M. A., Bennasar-Veny, M., Artigas-Lelong, B., Salvà-Mut, F., Pou, J., Capitán-Moyano, L., García-Toro, M., & Yáñez, A. M. (2022). Health and access to healthcare in homeless people: Protocol for a mixed-methods study. Medicine, 101(7), e28816. https://doi.org/10.1097/MD.0000000000028816

Brummer, J., Bloomfield, K., Karriker-Jaffe, K. J., Pedersen, M. M., & Hesse, M. (2023). Using the alcohol use disorders identification test to predict hospital admission for alcohol-related conditions in the Danish general population: a record-linkage study. Addiction (Abingdon, England), 118(1), 86–94. https://doi.org/10.1111/add.16034

Kwame, A., & Petrucka, P. M. (2021c). A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00684-2

Willison, C., Unwala, N., Singer, P. M., Creedon, T. B., Mullin, B., & Cook, B. L. (2024). Persistent Disparities: Trends in Rates of Sheltered Homelessness Across Demographic Subgroups in the USA. Journal of racial and ethnic health disparities, 11(1), 326–338. https://doi.org/10.1007/s40615-023-01521-9  Functional Assessments and Cultural and Diversity Awareness in Health Assessment

NURS-6512 Week 2: Assignment 1: Building a Health History With Cultural and Diversity Awareness

NURS-6512 Week 2: Assignment 1: Building a Health History With Cultural and Diversity Awareness

BUILDING A HEALTH HISTORY: COMMUNICATING EFFECTIVELY TO GATHER APPROPRIATE HEALTH-RELATED INFORMATION

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting.

There may also be significant cultural factors. In May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged Black women to maintain a weight above what is considered healthy. Randall explained from her observations and her personal experience, as a Black woman, that many African American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).

Randall’s statements sparked a great deal of controversy and debate at the time; however, they emphasize an underlying reality in the healthcare field: Different populations, cultures, and groups have diverse beliefs and practices that impact their health. APRNs and other healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

As an advanced practice nurse, you must build a patient health history that takes into account all of the factors that make a patient unique and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with each patient, but it will also enable you to more effectively gather the information needed to assess a patient’s health risks.

For this first Assignment, you will take on the role of an APRN who is building a health history for a particular patient assigned by your Instructor. You will consider how social determinants of health and specific cultural considerations will influence your interview and communication techniques as you work in partnership with the patient to gather data for an accurate health history.

Note: You are expected to draw on the resources for both Week 1 and Week 2 when completing your Assignment.

RESOURCES

 

Be sure to review the Learning Resources before completing this activity.
Click the weekly resource links to access the resources.

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To prepare:

• Reflect on your experience as an advanced practice nurse and on the information provided in the Week 1 Learning Resources on building a health history and the Week 2 Learning Resources on diversity issues in health assessments.
• By Day 1 of this week, your Instructor will assign a case study for this Assignment. Note: Please see the Course Announcements section of the classroom for your Case Study Assignment.
• Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of your assigned patient.
• Consider how you would build a health history for the patient. What questions would you ask? How might you target your questions based on the patient’s social determinants of health? How would you frame the questions to be sensitive to the patient’s background, lifestyle, and culture?
• Identify any potential health-related risks, based on the patient’s age, gender, ethnicity, or environmental setting, which should be taken into consideration.
• What risk assessment instruments would be appropriate to use with this patient?
• What questions would you ask to assess the patient’s health risks?
• Select one (1) risk assessment instrument discussed in the Learning Resources, or another tool with which you are familiar, related to your selected patient.
• Develop five (5) targeted questions you would ask the patient to build their health history and to assess their health risks.
• Think about the challenges associated with communicating with patients from a variety of specific populations. What communication techniques would be most appropriate to use with this patient? What strategies can you as an APRN employ to be sensitive to different cultural factors while gathering the pertinent information?

Assignment: Building a Health History With Cultural and Diversity Awareness  

Include the following:

• Explain the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Be specific.
• Explain the issues that you would need to be sensitive to when interacting with the patient, and why.
• Describe the communication techniques you would use with this patient. Include strategies to demonstrate sensitivity with this patient. Be specific and explain why you would use these techniques.
• Summarize the health history interview you would conduct with this patient. Provide at least five (5) targeted questions you would ask the patient to build their health history and to assess their health risks. Explain your reasoning for each question and how you frame each for this specific patient.
• Identify the risk assessment instrument you selected, and then justify why it would be applicable to your assigned patient. Be specific.

BY DAY 7 OF WEEK 2

Submit your Assignment.

SUBMISSION INFORMATION

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1. To submit your completed assignment, save your Assignment as WK2Assgn1_LastName_FirstInitial
2. NURS-6512 Week 2: Assignment 1: Building a Health History With Cultural and Diversity Awareness
3. Then, click on Start Assignment near the top of the page.
4. Next, click on Upload File and select Submit Assignment for review.

 

NURS-6512N Week 3: Case Study Assignment: Differential Diagnoses and Diagnostic Testing of a 92-Year-Old African American Male

NURS-6512N Week 3: Case Study Assignment: Differential Diagnoses and Diagnostic Testing of a 92-Year-Old African American Male

Assignment: Diagnostic Reasoning 

Include the following:

• Identify the patient’s chief complaint.
• Identify what physical exams and diagnostic tests would be most appropriate to gather more information about the patient’s condition. Be specific and explain your reasoning.
• Explain how the results would be used to make a diagnosis.
• Identify three to five (3–5) possible conditions that may be considered in a differential diagnosis for the patient. Explain your thinking.

Case Study Assignment: Differential Diagnoses and Diagnostic Testing of a 92-Year-Old African American Male

Hypertension is one of the most common non-communicable lifestyle diseases that usually affect persons as they grow older. One of the causes is the inevitable stiffening of the walls of blood vessels through calcification as one ages. Combined with atherosclerosis due to hyperlipidemia, this is because of the higher prevalence of hypertension in the older generation (Barrett et al., 2019; Jameson et al., 2022). The patient discussed in this case is an elderly African American male with a history of hypertension who is non-compliant with taking his medications. On admission to the Emergency Department (ED), his BP is found to be high at 210/ 100 mmHg. The patient was brought by his daughter to the ED, and he presented with slurred speech. According to the Mayo Clinic (2022), dysarthria is a primary symptomatic indication of hemorrhagic stroke that affects the right side of the brain. Dysarthria is a disturbance in spoken speech by the patient as the speech center is impaired by the blood that infiltrates the brain parenchyma after a hemorrhagic stroke occurs. The patient high blood pressure could likely have been caused by non-adherence to his prescription or the ineffectiveness of the current medications he is on.

Background

Dysarthria is caused when neurons that send signals to control the tongue, face, and throat muscles are affected. Therefore, the muscles in these places become poorly coordinated due to the deranged neuronal signaling and weak and slow response (Barrett et al., 2019; Chiaramonte & Vecchio, 2020). The patient’s speech, affected by dysarthria, becomes slurred, slow, and incomprehensible. The increased blood pressure increases artery pressure in the brain, causing them to burst, resulting in hemorrhagic strokes. The neurons in the speech center get compromised; hence, they cannot effectively send nerve impulses to the neuromuscular junction for adequate movement required for speech.

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Convenient Diagnostic Tests and Physical Examination for the 92-Year-Old Patient

The brain has membranes that coordinate and send messages regulating our functions.  The brain parenchyma is referred to as subarachnoid hemorrhage or SAH. However, another type of hemorrhagic stroke affects the actual brain parenchyma and, by extension, the speech center and is referred to as intracerebral hemorrhage or ICH (Barrett et al., 2019; Jameson et al., 2022). In this case, it is most likely that the type of hemorrhagic stroke he suffered from was the ICH type. Ball et al. (2023). A physical assessment, including a neuro assessment, is essential to focus on during patient systems assessment.

The neurologic examination will not stop at that but will also assess several neurological signs. A patient who has suffered a hemorrhagic stroke such as this one will usually also display signs that indicate meningeal irritation in the absence of inflammation. These signs indicate meningeal irritation, called meningism (Ball et al., 2023; McCance & Huether, 2019). In this case, a positive Kernig sign and a positive Brudzinski sign indicate the presence of meningismus or nuchal rigidity. A positive Brudzinski sign is elicited when hip flexion is not voluntary as the patient’s neck flexes. On the other hand, pain when the knee is extended as the thigh is bent at an angle of 90 degrees indicates a positive Kernig sign. Other appropriate tests for this patient include an electroencephalogram or EEG, an electrocardiogram or EKG, a chest X-ray, a computed tomography (CT) scan of the brain, and a magnetic resonance image (MRI) Differential Diagnoses and Diagnostic Testing of a 92-Year-Old African American Male.

Regarding imaging studies and evidence-based practice (EBP), a CT scan and an MRI should be the first imaging done. In this case, a CT scan gives the neurologist a much broader picture of any brain damage that this patient may have suffered. CT cans are more conclusive in detecting any bleeding in the brain.  In this case, An MRI will also be helpful. Apart from the primary hemorrhage, there will also be subsequent hemorrhages in the form of abnormalities such as cerebral vein thrombosis and cavernomas, amongst others. An MRI will help detect any persistent bleeding, as well as surgeries and treatment plans.

Other Laboratory Blood Tests

Apart from suffering from hypertension, the patient could also be suffering from a variety of coagulation abnormalities and hemorrhagic conditions. Specific blood tests must also be done to measure these and rule them out in the patient. These include prothrombin time or PT (which can be translated to the international normalized ratio or INR), platelet count, and the activated partial thromboplastin time or aPTT amongst others (Jameson et al., 2022; McCance & Huether, 2019). The presence of thyroid antibodies, immunoglobulins, antinuclear antibodies, and the rheumatoid factor must also be quantitatively assessed. This is to rule out other conditions, such as vasculitis. Lastly, liver function tests and a renal profile may have to be performed as well to rule out kidney and liver failure Differential Diagnoses and Diagnostic Testing of a 92-Year-Old African American Male.

Employment of the Tests to Make a Diagnosis

The above tests and investigations would show that this patient has a diagnosis of hemorrhagic stroke. The impaired speech and the elevated blood pressure on assessment also support this diagnosis. Positive aPTT, PT, and INR tests would also point to a disorder of clotting that may have supported the hypertension in causing the stroke. The outcomes of these various tests and evaluations will be interpreted in light of the subjective information already in the clinician’s hands.

The Most Probable Differential Diagnoses for the Patient

According to the Mayo Clinic (2022) and Jameson et al. (2022), the other conditions that may also cause dysarthria and get mistaken for hemorrhagic stroke (differential diagnoses) include:

• Transient ischemic attack (TIA).
• Hypertensive encephalopathy.
• Amyotrophic lateral sclerosis or ALS.

The thinking behind this is that these conditions would cause similar dysarthria. Differential Diagnoses and Diagnostic Testing of a 92-Year-Old African American Male

References

Ball, J., Dains, J.E., Flynn, J.A., Solomon, B.S., & Stewart, R.W. (2023). Seidel’s guide to physical examination: An interprofessional approach, 10^th ed. Elsevier.

Barrett, K.E., Barman, S.M., Brooks, H.L., & Yuan, J. (Eds) (2019). Ganong’s review of medical physiology, 26^th ed. McGraw-Hill Education.

Chiaramonte, R., & Vecchio, M. (2020). A systematic review of measures of dysarthria severity in stroke patients. PM&R, 13(3), 314-324. https://doi.org/10.1002/pmrj.12469

Jameson, J.L., Fauci, A.S., Kasper, D.L., Hauser, S.L., Longo, D.L., & Loscalzo, J. (Eds) (2022). Harrison’s Principles of Internal Medicine, 21^st ed. McGraw-Hill Education.

Mayo Clinic (2022, May 17). Dysarthria. https://www.mayoclinic.org/diseases-conditions/dysarthria/symptoms-causes/syc-20371994

McCance, K.L. & Huether, S.E. (2019). Pathophysiology: The biologic basis for disease in adults and children, 8^th ed. Mosby/Elsevier. Differential Diagnoses and Diagnostic Testing of a 92-Year-Old African American Male

Gloria Jenkins iHuman

Gloria Jenkins iHuman

Patient Demographics

Patient’s Name: Gloria Jenkins

Age: 65-years-old

Gender: female

HPI (History of Present illness):

Gloria Jenkins is a 65-year-old female who presented to the clinic with the chief complaint of back pain that started two days ago while she was working. The pain is located on her lower back and is described as sharp in character, felt deep inside her back not on the skin, and is graded as 7/10 on pain scale. The pain is present at all times (continuous) and is unaffected by bending forward or sitting. The pain makes it hard for her to sleep and worsens when she is working, on moving, rolling over in bed, and walking and standing for a long time Gloria Jenkins iHuman. She is currently unable to lift anything. The pain has no known relieving factors, and the patient has not tried any treatments for the pain. The pain radiates to the right leg, causing pain in the leg. The pain has since onset not gotten any better and the patient reports that she has never had such pain before. She denies any recent trauma or fall or anything like it. There is no associated weakness or numbness, or tingling sensation on her legs. However, she reports difficulty moving due to the pain. She denies any history of spinal disease or popping sensation heard before the onset of the pain.

Problem Statement:

Ms. Jenkins, a 65 years old female who present with the acute onset of Left Back Pain on a pain (7/10) 2 days ago following the moving of heavy tables at work. The pain starts in her back and radiates down right leg impairing both gait and her sleep. Upon PE, it shows positive straight leg raise on both right with positive finding with contralateral leg raise, RLE sensory, motor and reflex deficits. She denies fever/chills/night sweat, bladder/bowel dysfunction and denies unintentional weight loss. She has PMH of osteoporosis, 40-pack years smoking history and steroid use history. Family history of cancer and heart disease.

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Gloria Jenkins iHuman Primary Diagnosis

Herniated intervertebral disk.

The diagnosis for Ms. Jenkins is Herniated intervertebral disk. A Pt experiences herniated intervertebral disk when a part of the muscle pushes through an annulus crack. The herniated disc causes compression of nerves orth spinal cord leading to neurological deficits (motor, sensory, or reflex deficits) (Dydyk, Massa, & Mesfin, 2021). The symptoms include pain in the foot, leg, arm, or back (Fujii et al., 2019). The Pt may also feel weakness or numbness in the leg or arm and irritate nearby the nerves. The diagnosis for the Pt is Herniated intervertebral disk because she has Herniated intervertebral disk symptoms such as RLE sensory, back pain radiating on right leg, and positive straight leg raise on both R. the risk factors for herniated intervertebral disk include weight, genetics, smoking and being lifting heavy material. The patient has a 40-year pack year smoking history and she is more likely to experience herniated intervertebral disk. The disease can be managed conservatively with NSAIDs and physical therapy as the first line treatment modalities (Dydyk, Massa, & Mesfin, 2021). Other management options include epidural steroid injection and surgery for pain that is refractory to other management options.

Differential Diagnoses

Osteoporotic compression fractures

Osteoporotic compression fractures take place at the vertebral body causing the spine to collapse and weaken. The symptoms include back pain, loss of height, problems in controlling bowels and bladder, hunched over appearance. One of the symptoms for osteoporotic compression fractures possessed by the patient includes back pain. Osteoporotic compression fractures can be ruled out because the patient has no lost height and is able to control bowels and bladder. Like disc-herniation, surgery is only considered for severe debilitating symptoms of this disease.  Its management is often physiotherapy and analgesic for pain relief.

Spinal neoplasm

This refers to any malignant tumor occurring within the spine. These are the primary tumors that could occur within the spinal cord, excluding tumors of the meninges, autonomic nervous system, and peripheral nerves. However, all these neoplasms could lead to back pain, variable. Radiculopathy, and spinal cord compression syndrome. Symptoms include back pain radiating to other parts of the body, less sensitive to pain, cold and hear, loss of bladder or bowel function and difficulty walking (Din et al., 2022). The patient is experiencing back pain that radiates to the leg which is an indication of spinal neoplasm. Spinal neoplasm can be ruled out because the patient denied bowel and bladder dysfunction.

Muscular strain

The last alternative diagnosis is muscular strain. Muscular strain is an injury to tendon or muscle that connects bones to muscles. The symptoms include pain or tenderness, bruising, swelling, and muscle weakness (Urits et al., 2019). The patient has back pain but did not report swelling, and bruising.

Pharmacological Therapies

• Ibuprofen OTC 400mg PO q 4-6 h PRN for pain and inflammation. Do not exceed 2400mg/day. Take with food to avoid IG upset.
• Analgesic – Morphine sulfate intramuscular 5 mg STAT; Shift to tramadol 25 mg

tablets once daily in the morning to be taken orally for a week. Dispense 7 tables.

Consider epidural steroid injections, however it only provides short-term use.

Risk factors: 

Complete Hysterectomy, thin bones, Hypertension, asthma-steroid use

Gender: Female

Age:65

Family History: Cancer (mother) and Heart issues (father).

Social Determinants of Health

• Educate to quit smoking.

 Health Promotion:

• Education on lifestyle modification to maintain a healthy weight and better.

control of her diabetes and hypertension.

• Enrollment is appropriate hypertension or cardiovascular and smoking cessation.

programs.

• Education on better lifting mechanisms and the need to reduce straining at work.
• Encourage for adequate bed rest and rest in between shifts.

Patient education:

• Explanations and advice given to patients and family members.
• Informed the patient that the disease is often self-limiting in most patients, and that the symptoms will go away on their own within two to twelve weeks.
• Educate on physical activity and diet modification to maintain a healthy weight.
• Advised on the need to adhere to medication for better controlled BP and blood sugar levels.
• Educated to stop smoking and advised to join smoking cessation programs.
• Educate to minimize straining at work and apply good lifting body mechanics or techniques.
• Advised to ensure adequate bed rest and to take adequate rests between shifts at work.

Follow-up/Disposition

• Upon discharge, follow up with the patient in a week to reevaluate pain levels and

readjust or change medication as required to possible NSAIDs.

• Referral to the physiotherapist after three weeks for physical therapy.
• Follow -up for possible surgery if indicated.

References

Din, R. U., Cheng, X., & Yang, H. (2022). Diagnostic role of magnetic resonance imaging in          low Back pain caused by vertebral endplate degeneration. Journal of Magnetic             Resonance Imaging, 55(3), 755-771.

Dydyk, A., Massa, R., & Mesfin, F. (2021). Disk Herniation. Stat Pearls [Internet]. Treasure

Island (FL): Stat Pearls Publishing.

Fujii, K., Yamazaki, M., Kang, J. D., Risbud, M. V., Cho, S. K., Qureshi, S. A., … & Iatridis,   J. C. (2019). Discogenic back pain: literature review of definition, diagnosis, and            treatment. JBMR plus, 3(5), e10180.

Urits, I., Burshtein, A., Sharma, M., Testa, L., Gold, P. A., Orhurhu, V., … & Kaye, A. D.   (2019). Low back pain, a comprehensive review: pathophysiology, diagnosis, and       treatment. Current pain and headache reports, 23, 1-10 Gloria Jenkins iHuman.

Multicultural nursing

Multicultural nursing has become increasingly important in recent years as the healthcare system continually strives to provide quality care that meets the needs of a diverse patient population.

Nurses must recognize and understand each patient’s unique needs, from language barriers to cultural and religious views. This article will explore the various aspects of multicultural nursing, including its purpose, key components, and importance in modern healthcare.

What is multicultural nursing?

Multicultural nursing focuses on the cultural differences between patients and how they can affect their health. It considers the various beliefs, values, language barriers, and customs of different ethnic groups to provide them with effective healthcare. Multicultural nursing helps bridge the gap between medical care providers and patients from diverse backgrounds by recognizing unique needs and facilitating better communication.

Multicultural nursing aims to ensure that all individuals receive equitable healthcare regardless of race, ethnicity, culture, or language. By considering a patient’s beliefs, values, and traditions, this practice can help build trust between provider/patient relationships while ensuring that medical services are tailored to their needs. This approach has improved adherence to treatments and overall patient satisfaction and compliance with follow-up care.

Background of multicultural nursing

Multicultural nursing has a rich and varied history. Developed in the 1970s, multicultural nursing was born out of the Civil Rights Movement and its associated need to recognize diversity as an important factor in providing quality health care to all individuals. It is meant to incorporate an awareness of cultural differences in all aspects of medical practice, patient-nurse relationships, and health outcomes.

This concept was initially developed by Madeleine Leininger, a nursing theorist who focused on caring for individuals from various backgrounds. She and many other theorists have since dedicated their work to exploring how cultural differences can be addressed in the clinical setting, with goals such as increasing access to health services for vulnerable populations and improving healthcare outcomes among minority groups. This field has evolved with advances made through research into the unique needs of people from diverse cultures, religions, ethnicities, genders, and social classes.

Reliable and valid instrument for evaluating multicultural nursing competence

A reliable and valid instrument for evaluating multicultural nursing competence is a must in the current times. Healthcare organizations are increasingly becoming diverse, with nurses from different cultures, backgrounds, and beliefs.

As such, it has become necessary to have an evaluation tool that accurately assesses the competency of these nurses in providing culturally sensitive care. This instrument should be reliable so that it can be used consistently over time to measure performance and validate test results.

Using reliable and valid instruments to evaluate multicultural nursing competence allows healthcare organizations to identify strengths and weaknesses among their staff by taking into account the various cultural needs of their patients.

This helps ensure that all patients receive quality care regardless of their culture or background. This instrument also allows organizations to make well-informed decisions regarding promotion or hiring when considering how well a nurse can provide culturally appropriate care.

Congruency and conflicts between bioethics and multicultural nursing

Bioethics and multicultural nursing are interconnected practices that promote ethical, equitable care for all patient populations. When these two fields of study come together in practice, important values such as cultural sensitivity, dignity, and respect for the individual are respected.

There can be differences in opinion between bioethics and multicultural nursing on a case-by-case basis which may lead to conflict between the two approaches. The ethical principles of autonomy, beneficence, and justice form the foundation of biomedical ethics.

At the same time, multicultural nursing encourages us to consider each individual’s unique social identity within their cultural context. While both aim to achieve healthcare justice and quality patient outcomes, they may differ in how they approach a particular situation or clinical decision.

As both fields expand and develop with new information, it is important to consider how these two disciplines intersect. Congruency between bioethics and multicultural nursing can improve patient care outcomes, while conflicts can create ethical dilemmas for healthcare professionals.

Patient engagement in multicultural nursing

Patient engagement in multicultural nursing is an important topic for any healthcare provider. Understanding the needs of all patients, regardless of culture or background, is essential for delivering quality care. Multicultural nursing focuses on providing culturally competent care to patients from diverse backgrounds.

It requires nurses to be aware of and sensitive to cultural differences between individuals and their families and be willing to accommodate them to provide the best possible patient experience.

Patient engagement plays a key role in successful multicultural nursing. When nurses can establish trust with their patients, they can better identify and understand the patient’s cultural values, beliefs, and preferences regarding health treatment options. This understanding allows them to tailor the care plan accordingly while meeting the patient’s physical and psychosocial needs.

Benefits of multicultural nursing

Multicultural nursing is an important part of healthcare today. It provides a variety of benefits to both patients and healthcare staff, as well as the overall healthcare system. By understanding different cultures’ diverse needs and beliefs, nurses can provide better quality care tailored to each patient’s specific needs and preferences. Here are some ways multicultural nursing can improve overall healthcare outcomes.

• Nurses trained in cultural competency understand how to effectively communicate with people from different backgrounds, making them better equipped to answer questions or concerns about their health or treatment plan. This enables nurses to build trust with their patients and provide more detailed information regarding diagnoses or treatments, which can increase compliance rates among patients
• By utilizing this type of nursing, patients can feel more at ease as they are surrounded by people who understand their culture and its nuances
• Multicultural nursing takes into consideration the unique aspects of each patient’s culture, such as customs, language barriers, socio-economic status, and religions, when providing care
• This type of nursing allows nurses to provide holistic treatment to individuals from all walks of life in a way that speaks directly to them
• Through multiculturalism, nurses can bridge gaps between traditional healthcare models and patients from diverse backgrounds.

Challenges in Multicultural Nursing

The world of nursing is becoming more multicultural, with healthcare professionals from all walks of life caring for patients from various cultural backgrounds. However, this can present nurses with unique challenges that may impede their ability to provide effective and compassionate care. As the population continues to become increasingly diverse, nurses need to recognize and be aware of the potential issues they may face when working in a multicultural environment.

• One challenge associated with providing care in a multicultural setting is understanding the specific cultural beliefs and practices that affect how patients view health, illness, and treatment
• Language barriers can be a major challenge in multicultural nursing. Many healthcare providers may not speak the same language as their patients or understand cultural nuances that could affect communication and understanding between patient and provider
• Another challenge in multicultural nursing is creating culturally competent care plans for each patient. Each culture has its values, customs, and norms that may differ greatly from one another

Strategies to support diversity in nursing

One approach involves providing cultural competency training tailored to the diverse patient population in any given area. This training helps nurses understand different cultural norms and values to provide care more effectively when interacting with patients from different backgrounds.

Another important strategy is creating an inclusive environment within nursing departments that encourages individuals from all walks of life to feel welcome and supported while developing their professional skills. This could include things like having resources available to provide support on issues related to equity and inclusion, as well as looking at ways staff members can work together collaboratively towards common goals despite their differences.

Additionally, healthcare organizations should encourage strong communication between the various nursing teams by holding regular meetings or events where nurses from different backgrounds can come together and share their perspectives on diversity issues.

Cultural competency education for nurses

Cultural competency education for nurses helps to bridge the gap between providing quality care and respecting diverse cultures. As more people than ever come into contact with healthcare services, nurses must understand the values and beliefs of their patients to provide them with the best possible care.

Cultural competency education typically includes communication strategies, cultural awareness, sensitivity training, language proficiency, ethical considerations, patient-centered approaches, and respect for diversity.

It also covers strategies for recognizing and responding appropriately to different cultural values within healthcare settings. With this education, nurses are better equipped to identify potential barriers in treatment plans due to language or culture-based misunderstandings or biases.

Bottom line

Multicultural nursing is an important concept in modern healthcare. It allows nurses to serve the needs of diverse populations better, helping to provide equitable and inclusive care. Nurses must work to understand different cultures and their impact on patient care, as well as tailor their approach to meet the needs of each patient. With continuing education and dedication, nurses can become more culturally competent and successfully deliver compassionate care to all patients regardless of cultural background.

Philosophy and Logic Essay Writing

Philosophy and Logic Essay Writing

Introduction to Philosophy PHIL 1200 Unit 1 1
Unit 1
Introduction to Philosophy
Introduction
To act without clear understanding, to form habits without investigation, to follow a path all one’s
life without knowing where it really leads—such is the behaviour of the multitude. (Meng-Tse)
Many people would sooner die than think. In fact they do. (Bertrand Russell)
This unit has two distinct sections designed to acquaint you with the nature of philosophical
reasoning:
The first part contains:
• a brief characterization of philosophy;
• a discussion of the attitudes that are important to doing philosophy;
• an explanation of the value of philosophy; and
• an explanation of the relationship between philosophy and other fields of theoretical inquiry.
The second part is an introduction to logic.
Learning objectives
Upon completion of this unit, you should be able to:
1. outline the basic methodology of philosophy;
2. describe the basic intellectual attitudes necessary for being a good philosopher; and
3. outline the basic concepts and rules of logic.
Assigned reading/viewing/listening
1. Plato, Socrates’ defence (Apology) – http://classics.mit.edu/Plato/apology.html Apology by Plato
translated by Benjamin Jowett
2. Sober, Elliot. 2001. Deductive arguments and inductive and abductive arguments. In Core
questions in philosophy, 3rd ed., 7-34. New Jersey: Prentice-Hall.
ON RESERVE from Off-Campus Library Services.
3. Crossley, David J., and Peter A. Wilson. 1979. Don’t let them fool you: Some common fallacies.
In How to argue: An introduction to logical thinking, 39-52, 236-237. New York: McGraw Hill.
Available in your readings package
4. Crossley, David J., and Peter A. Wilson. 1979. Some perplexing arguments: The dilemma and
the reduction. In How to argue: An introduction to logical thinking, 151-168, 257-259. New York:
McGraw Hill.
Available in your readings package
Required viewing (linked in the instructional content)
Examined Life Video: What is Philosophy?
2
Learning activities
Discussion overview
When you are ready to become involved with the discussions, access the discussion area for Unit 1
in your course web site. Other students will then post feedback about your points, questions for
clarification, or additional statements to add to your original argument. If you want to respond to
another student’s comments, you can do so by selecting the reply option.
The central purpose of the discussion will be to develop the theme of “moving the discussion along”
even if it involves asking another question that simply rewords the original or perhaps one that
changes the approach to an answer. To this end of ‘moving the discussion along’ you may want to
engage with one of the questions you saw in the self-tests – especially the questions that didn’t have
an automatic response provided. In any case, you may find that those self-test questions take on a
new relevance when you run into them again during your online discussions.
Once discussion of one unit has been completed, you are ready to go on to the next unit.
In each unit you will see, “Intuition pumps” used as motivating questions. These questions are
intended to get at our “gut feeling” about our answer to a certain question. That is, once we strip
away all assumptions and personal investment in a response to a question what is our answer?
Some regard this, colloquially, as getting to the heart of the matter.
Your answers to the questions will not be graded, they are provided to give opportunities to help you
understand the concepts in the unit rather than just trying to memorize them. Therefore, while there
is no initial grade assigned to these exercises, doing them should help in attaining the overall grade
you desire for this course.
It is important to note that your instructor will not respond to each posting. Your instructor will oversee
the discussions and periodically join in to help guide and facilitate them when necessary. The
general goal of these exercises is for you to start and build a discussion with your classmates based
on the questions asked in the course manual.
Discussion focus
• This unit and this course start with discussing the nature of a
philosophical question. This is motivated by asking: what was Socrates
doing in his day, and then using that as an example of what philosophy is
doing today.
Question: What characterizes a philosophical question?
How to proceed
• Complete your readings and view the online videos. Overall, the best approach to this
introductory unit is to deal with it in two parts.
• Participate in the online discussion. Remember, each unit has a particular focus for the
discussions.
Part 1
1. Read the sections “What philosophy is” and “Areas to be studied” in the instructional content for
this unit.
2. Links to video clips are inserted throughout the instructional content. View each video when it
occurs in the instructional content.
3. Read Socrates’ Defence (Apology) by Plato in your required readings.
Introduction to Philosophy PHIL 1200 Unit 1 3
Suggestion:
Make careful notes on the Plato reading as the first
assignment will require you to refer to it in some detail.
Part 2
4. Read the section “A brief introduction to logic” in the instructional content.
5. Links to video clips are inserted throughout the instructional content. View each video when it
occurs in the instructional content.
6. Read “Deductive Arguments” and “Inductive and Abductive Arguments” by Elliot Sober in the
required readings.
7. Now that you have participated in the online discussion, completed your readings, and viewed
the video clips, prepare for and work on your assignment by completing the following:
a. Do the online self-test questions and check your responses against the answers provided.
b. A glossary of key terms is provided in the online course; consult it whenever you are unsure
about the meaning of a technical term.
c. Complete the unit assignment and submit it online. Be sure to submit the honesty
declaration when you submit assignment 1.
Instructional content
What philosophy is
Philosophy is not an unsystematic, disorganized, free association of ideas strung together in an
attempt to find some “hidden” truth, or an attempt to satisfy some need to “let it all hang out.”
Students who take a course in philosophy because they believe it to be an opportunity to obtain a
good grade for a minimal amount of work are inevitably disappointed. They seem to feel that,
because they have a good imagination and a great deal to say, or perhaps because they are good at
getting the last word in arguments with their friends, they are already good philosophers. Typically,
these students do little work yet are surprised at how poorly they do on their assignments.
You should no more expect to be good at philosophy without studying and practising it than you
should expect to be a good doctor without studying and practising medicine. Philosophy can be fun,
but it is first and foremost an academic discipline with stringent standards. Remember, you have to
be able to defend your philosophical views. How well they stand up to criticism is a mark of how well
you do philosophy. In this course you are going to find that you have to present arguments for certain
points of view, and that these arguments will be criticized as to how well-reasoned they are. This
course is not a presentation of facts to be memorized. You should grapple with the issues and arrive
at your own conclusions.
Required viewing
Examined Life Video – What is Philosophy? [Length: 30 minutes]
©1998. INTELECOM Intelligent Communications. All rights reserved. No alteration, duplication or downloading is permitted
with authorization. Reproduced with permission from Distribution Access.
4
A characterization of philosophy
Philosophy is quite different from all other fields, but the differences are complex and somewhat
difficult to specify. Indeed, “What is philosophy?” is itself an important philosophical question, one
that divides philosophers at least as much as any other. However, we can give a rough description of
philosophy.
Let us briefly consider the history of philosophy. At one time what was called philosophy
encompassed all fields of theoretical inquiry (including physics, chemistry, and psychology). As
inquiry proceeded, one by one each field reached a point where there was one or perhaps two,
dominant theories, and a more or less accepted empirical decision procedure or methodology for
answering questions within the field. An empirical methodology is one that settles questions through
the use of observation. Once a field becomes empirical, it has moved away from philosophy and
becomes a discipline unto its own (a recent example is the field of psychology). Historically then, the
last philosopher to study a particular area, is often better known as the founder of a new field; for
instance, Isaac Newton would have considered himself a philosopher, but we know him today as a
physicist.
Although the fields that have left philosophy still rely upon philosophical methodology (debate) to
some extent, there is clearly in each case an emphasis upon scientific or empirical methodology.
These fields, unlike philosophy, are said to depend upon empirical data or testing for solving their
problems. Philosophy itself depends upon empirical data or tests for the solution of some of its
questions (this should not be too surprising for a field that has spawned so many empirical
sciences), but by and large it does not. Rather, questions are debated (and solved or not solved) by
the dialectical process whereby arguments are advanced on each side of an issue. Perhaps that is
the one question that all philosophers will answer in the same way: the methodology of philosophy is
argument and counter-argument. To put it simply, philosophers debate within a field until the field is
dominated by one or two main theories and has developed a scientific or empirical methodology for
resolving questions. At that time, the field is likely to leave the domain of philosophy (perhaps taking
some philosophers with it and, in a sense, making them scientists). In other words, as philosophy is
successful, it loses some of its areas of inquiry to science. Thus far, apart from the reference to the
centrality of debate, not much has been said about the proper methodology of philosophy. Opinions
on this have varied, and still do. In some traditions, philosophy has been considered the search for
truths that are available to the human intellect independently of the making of observations. In this
century one philosophical movement considered that the task of philosophy is not to come out with
proposals (truths) of its own, but rather to use special techniques to critically analyze the proposals
(truths) of science. Another modern movement views philosophical problems (such as the problem
of whether we have real free will) as unnecessary wasteful conundrums brought about by taking the
structure of our language too seriously. From this standpoint the philosopher’s task is a form of
therapy, to show people how to avoid getting caught up in problems that seem profound and
important, but are not.
At this point a word of caution is in order. Many students find these facts discouraging. Students
often come to philosophy in the hope of obtaining answers to their philosophical questions, or to find
a ready-made and comprehensive world view. To their disappointment they find that philosophers
have not settled matters amongst themselves. In light of what has been said, this is inevitable since,
if the matter were settled, then it would no longer be a part of philosophy.
Doing philosophy requires patience and determination. Answers to philosophical questions are to be
had for individual philosophers, even though philosophers as a group are not united in their answers.
As a philosopher, one must be prepared to work on philosophical questions and to accept the
likelihood of playing only a minor role in their solution. (This is actually true for all those working on
the bigger questions in all theoretical fields of inquiry.) Philosophy, however, as a form of inquiry, is
very important, as can be understood by considering the fields it has spawned.
However—and this is the real value of philosophy for the individual—the study of philosophy leads to
a better understanding of issues (the existence of God, the nature of morality, the nature of
perception, and so forth), that as thinking beings we cannot ignore. The study of philosophy also
helps to gain a perspective on the sciences and arts at least to the extent that they are struggles to
deal with these same issues. The practical value of philosophy is that it makes one a much better
thinker, and hence better equipped to do work in other fields.
Introduction to Philosophy PHIL 1200 Unit 1 5
The critical task of philosophy
Philosophy is doubt. (Montaigne)
You will probably do much better as a philosopher if you are willing to reflect upon your own beliefs,
and if you are able to admit when you are wrong. As you read about Socrates try to get a feel for a
type of penetrating, open, and honest search for truth. Socrates was able to show that his
contemporaries did not really know what they thought they knew. He did so by asking questions
about matters fundamental to various subjects. A question is said to be fundamental to a subject if
one’s knowledge claims about that subject presuppose knowledge of an answer to that question.
The usefulness of such questioning as performed by Socrates is twofold: it can show us when we do
not know what we think we know, and it can help us see more clearly what we do in fact know. In
other words, by questioning that which is accepted implicitly, we bring to consciousness more of our
own world view. To achieve these two benefits, one has to admit when one has been wrong, and one
has to openly and honestly reflect upon one’s beliefs.
The conceptual analysis task of philosophy
William James used to preach the “will to believe.” For my part, . . . what is wanted is not the
will to believe, but the wish to find out, which is the exact opposite. (Bertrand Russell)
The critical task leads quite naturally into conceptual analysis. Philosophers are constantly asking
each other what is meant by a concept or principle. They are forever looking for counterexamples to
proposed definitions and principles. (The nature of principles and definitions will become much
clearer as we work our way through this course.) This is a point that presents some difficulties in
understanding for students new to philosophy.
When it comes to meanings, it is legitimate to entertain ideas that do not refer to any existing things
for the purpose of producing counterexamples to any proposed definition or principle. Some students
have trouble with this, but you should keep in mind that when a term is defined, the definition is
meant to apply to all conceivable situations (or possible examples) to which the term could be
applied, whether those situations exist or not. For example, in response to the question, What makes
an act a good act from the moral point of view?, philosopher A might reply: an act is morally good if it
is an act that leads to the greatest happiness for the greatest number. Philosopher B might criticize
this principle by concocting a logically possible case that he would expect all would take to be a
counterexample to the principle. For example, philosopher B might say of philosopher A’s principle
that this is not what we mean by acts being morally good, because if it were, then we would agree
that if most people took extreme happiness in the torture of one individual, then torturing that
individual would be morally good. Since Philosopher B expects us to agree that such torture would
be morally bad, he expects us to reject the principle proposed by philosopher A. This is so, since B
thinks it evident that his example falls under the principle proposed by Philosopher A. Philosopher A,
who first proposed the principle, may agree and reject his own principle, or he may argue that B’s
proposed counterexample only seems to fall under his proposed principle, but does not really, and
so is not a counterexample. The debate may continue in this manner for quite some time, moving
through a series of proposed definitions and counterexamples. It is important to notice, however, that
the debate has been of value even though it has not been resolved. In this case it has been of value
because it has shed further light on what we mean by a “morally good act.”
In philosophy much time is spent searching for a principle or definition that will fit all the logically
possible examples. It is appropriate therefore to devise new examples that we agree will fall under
the concept being defined. The examples serve as tests for our definition or principle, to see if we
have actually captured what we mean. Of course, not all conceptual analysis is like this (as
sometimes definitions and principles are rejected simply because they are vague or ambiguous), but
a great deal of conceptual analysis is done this way. We mention this because many students see
this method of thought experiment as being quite mystifying. However, keep in mind that it is quite
appropriate to a field like philosophy.
This type of conceptual analysis may also seem puzzling because it implies that we already know
what we mean, but in another sense implies that we do not. This is quite correct, as we implicitly
know our concepts because we know how to use them (otherwise we would not be able to tell which
logically possible examples fell under them and which did not). However, we do not explicitly know
6
our concepts in the sense of being able to spell them out in the form of definitions or principles. The
articulation of our implicitly known concepts falls under the conceptual analysis task of philosophy.
Conceptual analysis yields knowledge in the sense of making explicit or articulate that which is only
known implicitly. But notice what kind of knowledge this is. It is knowledge of our concepts, but it
does not follow that our concepts are true, or that the principles we hold are those we ought to hold.
This type of analysis yields knowledge in another way, as when we discover that the concepts we
use daily are vague, ambiguous, indefensible, or incompatible with what has more evidence in its
favour. When this happens, we are forced to make a choice if we want a consistent and clearly
articulated world view. This of course leads to the constructive or speculative task of philosophy.
The constructive task of philosophy
What is the use of studying philosophy if all that it does for you is to enable you to talk with
some plausibility about some abstruse questions of logic, etc., and if it does not improve your
thinking about the important questions of everyday life .. ? (Ludwig Wittgenstein)
The constructive task can be characterized as the search for a consistent view as to how things, in
the broadest possible sense of that term (e.g., all things, including physical objects, ideas, pains,
human rights, morally good acts, etc.) hang together, in the broadest possible sense of that term.
(This is a paraphrase of Wilfrid Sellars’s characterization of philosophy.) In short, it is the search for
a consistent world view. But usually the constructive task is not so ambitious a project as an entire
world view. For example, a philosopher might present a system of morality he believes to be
consistent with all known moral codes, or a theory of physical objects that he believes to be
consistent with what we know about science, or a theory of how people ought to live that he believes
to be consistent with what we know about human nature.
Keeping in mind the concept of a world view with interconnected subject areas, try to find the
relationship between the subject matters of the different areas of this course. For example, if you
adopt current scientific method as a theory of knowledge for all subject matters, then you will have to
hold a view of ethics that is justifiable by current scientific method. If you are not careful, you might
unwittingly find yourself holding ethical beliefs that are incompatible with your theory of knowledge. In
this event you will have to change either your ethical beliefs or your theory of knowledge in order to
have a consistent world view. The point is, there are major themes running through the subject
matter of philosophy, such that what you assert in one area may have awkward consequences in
another.
To achieve a consistent outlook you must strive to discern the implications of any view you hold. This
will involve making the consequences of your theory explicit. It is considered bad philosophy to hide
awkward consequences or weak spots of a theory. Of course, we do care which views you support
(we are interested in truth after all), but as philosophers our concerns are usually with good
arguments. After all, philosophers believe that good arguments are the means by which we will find
the truth. Thus, if you can present strong arguments for a novel view, then you can get a top grade
just as easily as can the person who presents equally strong arguments for a “standard” view. But in
both cases, you should make explicit that which is significant and entailed by your view. If your view
is defensible but entails the significant fact that the earth is flat, then be explicit that your view entails
that the world is flat. (You will soon encounter many seemingly “crazy” views that made some
philosophers famous and widely respected. (Some of the views that we dearly hold now were once
viewed as “crazy” views.) One of the reasons for taking a philosophy course is to acquire the ability
to be honest in what your own views entail, and to develop skills for seeing how some beliefs entail
other beliefs. The history of ideas is replete with cases where great discoveries could have been
made, but were not because no one drew the right, and sometimes obvious, implications.
Philosophy is a search for truth, of course, but it is also a discipline where alternative world views
and theories are worked out in all their implications. In our search to explain the world, we need
different world views in our conceptual tool box, as it were, ready for use should a current world view
be judged inadequate. For example, materialism (the view that a person is entirely physical as
opposed to being both physical and spiritual) was not widely accepted until this century. Yet
philosophers have been developing the logic of materialism since the early Greeks. Thus, the
implications of materialism as a theory were already available before the many philosophers and
Introduction to Philosophy PHIL 1200 Unit 1 7
scientists of this century came to believe that dualism (the view that people are a composite of
physical bodies and nonphysical minds) should be rejected. This meant that the philosophical work
(including the debates) on materialism that took place over history have proved useful in this century,
even though that may have seemed unlikely when they occurred. We do not know beforehand which
theoretical turn our world views will take, but we do know that unless we have theoretical alternatives
worked out we will be stuck with our existing world views and their deficiencies. A consistent and
well-developed world view cannot be constructed overnight, but must be developed over a long
period of debate and research.
Areas to be studied
Logic
We have emphasized the point that argumentation is central to philosophy. Logic helps us to distinguish
good arguments from bad arguments. Logic is not an infallible antidote to sloppy reasoning, but provides
techniques that help us to discover inconsistencies, unacceptable inferences, and problematic premises
in arguments. Some of the questions we will examine are:
What is an argument?
What criteria distinguish a good argument from a bad argument?
If an opinion is supported by true premises, must we accept it?
What reason do we have for rejecting arguments that contain inconsistent premises?
Epistemology
It is commonly believed that we know many things on the basis of perception, that we know about the
mental states of other people through knowledge of their behaviour, and that we know there is a
physical world that is analyzed by science into its basic elements. Epistemology is the study of the
nature and rationality of these and other knowledge claims. It is an attempt to determine what we know
and on what grounds we can be said to know. Epistemology should not be confused with learning
theory, which is an area of psychology. Nor should epistemology be viewed as merely a descriptive
study of what certain people claim to know. Rather, it is a study of how we can rationally move from our
meagre evidence (just how meagre, relative to our conclusions, will become apparent later) to the
conclusions we believe to be justified. Some of the questions we will examine are:
What precisely are we aware of?
Is all empirical knowledge based on experience? Do people have innate knowledge?
Is the physical world as it seems?
Moral theory
As you will learn in the unit on morality, there is an important difference between what is called
normative ethics and what is called moral theory. Normative ethics is the presenting and defending
of different sets of moral rules. Moral theory is largely an analytic concern with the nature of moral
discourse, whether it is to be understood as referring to empirical properties, nonempirical
properties, or to no properties at all, and a concern with the conceptual analysis of moral discourse.
Some of the questions we will examine are:
What is the standard of right and wrong action?
Is there a standard of right and wrong action?
What is the meaning of “morally wrong” and “morally right?”
What is the relationship between morally wrong acts and punishment?
What does moral discourse refer to, if anything?
8
Metaphysics
Broadly stated, metaphysics is a study of the nature of reality, an attempt to answer questions about
whether things do or could exist as they are alleged to, and an analysis of the concepts fundamental to
all fields that make claims about existence. For example, metaphysical theories are put forth as to the
meanings of such terms as substance, causality, quality, relation, mind, God, and so on. Some of the
questions we will examine are:
Do people have immaterial minds?
Do sensible qualities exist in the absence of perceivers?
Do people have free will?
Does God exist?
The point has been emphasized already, but keep in mind that these are questions that cannot be
decided empirically. Chemists do not tell us what “substance” or “cause” mean. Nor could a
physiologist determine by empirical means whether or not people have immaterial minds. These, like
all philosophical questions, are solved, if at all, by debate. These debates may make some use of
empirical data, but this should not be construed as deciding these issues empirically.
A brief introduction to logic
The study of logic often helps students to think critically and clearly. As well it should assist you in
presenting, defending, and evaluating arguments. Logic is one of the oldest and certainly one of the
most useful of academic subjects. Few subjects can lay claim to the multiplicity of applications, both
technical and nontechnical, which logic enjoys. After all, every field of enquiry depends on the
application of sound reasoning for its success, and logic is an attempt to study the latter in a
systematic fashion. Logic also has an obvious application to the attempt of everyone to introduce and
sustain coherency among our beliefs about ourselves and the world in which we live.
Some terminology—arguments, premises, and conclusions
In ordinary language we often use words like ‘valid’, ‘argument’ and ‘fallacy’ that have very specific
and precise meanings in logic. For instance, ‘valid’ is often used as a synonym for ‘true’ or ‘good’;
such as “you make a valid point”. Unfortunately, within a philosophical context, this is an incorrect
use of the word valid that is correctly used to describe arguments, and not statements. It will be
important for you to understand these words correctly before tackling the rest of the course. An
argument is a group of statements, one or more of which (the premises) are claimed to provide
support for, or reasons to believe, the other (the conclusion). So, in effect, an argument is a group of
statements standing in the evidence conferring relation characterized by the support the premises of
the argument provide for its conclusion. Clarification is required at this point to avoid confusion with
the terminology being used. It is important to have a clear conception of the usage of the following
terms: “statements,” “proposition,” “argument,” and “inference.”
A statement is defined as a sentence that can be either true or false. Statements can be asserted or
denied, but not all sentences are statements. Questions, suggestions, and commands, for example,
are not true or false. Questions can be asked, suggestions offered, and commands given, but they
cannot be asserted or denied. The type of sentence which is typically a statement is a declarative
sentence. Declarative sentences can be asserted or denied and, as such, they have a truth value.
Statements also have meaning, or information content. However, this definition is usually reserved
for propositions. That is, the meaning or information content of a statement is a proposition.
Statements, as declarative sentences, express propositions. It is propositions then that are either
true or false. So, propositions can be asserted or denied or supposed (entertained). In other words,
no sentence is a proposition. But some sentences express propositions, where a proposition is a
state of affairs that does or does not obtain in the world. For example, when I hear you say, “Sam is
sad,” your words present to my mind the state of affairs, Sam’s being sad. I may believe in Sam’s
being sad, or in other words that that state of affairs obtains in the world; or disbelieve that it does; or
I might remain in doubt about whether or not it does. In this last case, I entertain the state of affairs,
Sam’s being sad, but I neither accept nor reject that it obtains in the world. While some authors
Introduction to Philosophy PHIL 1200 Unit 1 9
differentiate between these two terms, we will use the terms “statement” and “proposition”
synonymously.
There are two salient points with respect to the distinction between sentences and propositions. First
consider the example:
John disliked Paul.
Paul was disliked by John.
They are two different sentences in virtue of their differing arrangement. Yet both sentences express
the same proposition. That is, both sentences suggest the same possible state of affairs. So, when
we believe, disbelieve, or merely entertain that the proposition “John dislikes Paul” obtains in the
world, we are making the same claim for “Paul was disliked by John.”
Second, a sentence is a sentence of a particular language, whereas a statement is not peculiar to
any language. Consider the three sentences:
It is snowing.
Es schneit.
Il neige.
They are certainly different, as they are in three different languages: English, German, and French.
However, they all express the same proposition. That is, they all suggest that the same possible
state of affairs obtains in the world. Appropriately, we can then choose to believe, not to believe or to
simply entertain the possible state of affairs “It is snowing.”
Recall that an argument is a group of statements, one or more of which (the premises) are claimed
to provide support for, or reasons to believe, the other (the conclusion). Premises are statements
providing evidence for the truth of other statements; conclusions are statements for which other
statements provide evidence. Statements standing alone are not premises, nor are they conclusions,
and some groups of statements, for example, a mere list, are not arguments. Being a premise is a
relational status a statement acquires when one claims it provides evidence for another statement’s
truth; being a conclusion is a relational status a statement acquires when other statements provide
evidence for its truth. Being an argument is a relational status a group of statements acquire when
one statement in the group is a conclusion and the others are premises.
Many authors use the term “inference” interchangeably with “argument.” Be careful of this synonymy.
Properly an inference is a reasoning process whereas an argument is a set of statements, or
propositions, standing in an evidence conferring relation. As with “propositions” and “statements,”
this is a very weak identification. In both cases you should understand why the two sets of terms are
not precisely synonymous.
Logic will be concerned with these propositions, or statements, and the relations between them.
Recognizing arguments
In ordinary language, what we call “arguments” often involve much shouting and little persuasion. In
philosophy we hope for the opposite. The ability to recognize arguments is very important because, as
you probably already realize, not all sets of sentences express arguments, and in ordinary language
usage the intention of the speaker is not always straightforward. Generally, a passage contains an
argument if it purports to prove something; if it does not do so, it does not contain an argument.
There are two general conditions that must be fulfilled for a passage to purport to prove something.
First, at least one of the statements must claim to present evidence or reasons (factual claim).
Second, there must be a claim that the alleged evidence or reasons supports or implies something
(inferential claim).
There are numerous examples of non-argument forms such as passages lacking an inferential
claim, conditional statements, and explanations. Sometimes it is particularly difficult to distinguish an
argument from an explanation. The simplest way to understand the difference is to consider the
status of the conclusion. For example, consider the assertion “p because q.” Now, if all parties
concerned agree that q is true, then the assertion is an explanation. However, if the truth of q is a
contentious matter, then “p because q” is an argument. It is certainly interesting to know the different
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non-argument forms but the important skill is to be able to distinguish non-argument forms from
argument forms.
Deduction and induction
The distinction between deductive and inductive arguments is most important for the study of logic. You
should endeavour to ensure you understand the distinction thoroughly. A deductive argument is an
argument in which the premises are claimed to provide necessary support for the conclusion. In other
words, the premises are claimed to support the conclusion in such a way that if they are assumed true,
it is impossible for the conclusion to be false. On the other hand, an inductive argument is an argument
in which the premises do not provide necessary support for the conclusion. The premises only
“probability” support the conclusion. That is, the premises are claimed to support the conclusion in such
a way that if they are assumed true, then the conclusion is unlikely to be false and is probably true.
The salient point of the distinction between inductive and deductive arguments lies in the strength of
the respective argument’s inferential claims.
Validity, truth, soundness, strength, cogency
In further analyzing inductive and deductive arguments, the notions of truth, validity, soundness,
strength, and cogency play a central role by providing further categorization and classification of
inductive and deductive arguments. These terms are introduced to assist you to discriminate good
from bad arguments. You may have used many of these terms synonymously in day-to-day living,
but you will find that in the field of logic, they have distinct and specific meanings.
Arguments, either deductive or inductive, are neither true or false. Only statements or propositions
can be true or false.
Deductive arguments can be valid or invalid. A valid deductive argument is an argument in which the
premises support the conclusion in such a way that, if they are assumed true, it is impossible for the
conclusion to be false. This is because the conclusion of a deductive argument never includes
information not included in the premises. All valid deductive arguments are iron-clad, and
unsurprising. An invalid deductive argument is a deductive argument such that, if the premises are
assumed true, it is possible for the conclusion to be false.
An argument is either valid or invalid only on the basis of the logical relationship between the
premise and the conclusion, regardless of the content of the argument. In the following examples,
surprisingly, the first is valid, and the second is invalid.
Ex #1. All fish are doctors
All doctors are martians
Therefore all fish are martians.
Ex #2 All salmon are fish
All Cod are fish
All Salmon are cod.
Since validity and invalidity has nothing to do with the content of the argument, philosophers use the
concept of “sound” to describe arguments where the premises are true. A sound argument is a
deductive argument that is valid and has, in fact, true premises. Since an argument must be valid to
be sound, only deductive arguments can ever be sound.
The classifications “valid” and “invalid” are not used to describe inductive arguments. The premises of
an inductive argument provide only probable support for the conclusion. This is because the conclusions
of arguments include information not included in the premises; such as, the inference that all penguins
probably have webbed feet, based on the observations of relatively few penguins. Thus, it could never
be the case that the premises of an inductive argument could be said to support the conclusion in such
a way that, if the premises are assumed true, it is impossible for the conclusion to
Introduction to Philosophy PHIL 1200 Unit 1 11
be false. Inductive arguments are either strong or weak. Strength and weakness, unlike validity and
invalidity, generally admits of degrees. For example, consider the following two arguments:
1. 95 percent of all Albertans are rich.
Sally is an Albertan.
Therefore, Sally is rich.
2. 10 percent of all Albertans are rich.
Sally is an Albertan.
Therefore, Sally is rich.
Argument #1 is a strong inductive argument, whereas argument #2 is a weak inductive argument. A
strong inductive argument is an inductive argument such that, if the premises are assumed true, based
on that assumption, it is probable that the conclusion is true. A weak inductive argument is an inductive
argument such that, if the premises are assumed true, then based on that assumption, it is not
probable that the conclusion is true. A cogent argument is an inductive argument that is strong and
has, in fact, all true premises, and if either of these conditions are missing the argument is in cogent.
Good arguments versus fallacies
The last logic term you should know is ‘fallacy’. In common language we often use this word as a
synonym for “mistake” or “false”. In philosophy, we more precisely use ‘fallacy’ to refer to those
mistakes in reasoning that are worth studying because of their regular use and seductive nature.
The best way to think of fallacies is to consider three basic requirements for a good argument:
The premises must be:
1. Relevant to the conclusion.
2. Sufficient to warrant accepting the conclusion.
(The highest grade of logical sufficiency is attained in an argument that is deductively valid, for
then the conclusion cannot possibly be false, provided the premises are true. Frequently,
however, we must rely upon arguments that are not deductively valid, but have a reasonable
degree of inductive strength.)
3. Acceptable in their own right.
(The highest grade of logical acceptability is to have premises known with certainty to be true. But it
is reasonable to accept premises for which we have sufficient evidence to render them probable.)
A premise that is not acceptable, because we lack evidence for it, may of course turn out to be true.
Three basic fallacies or families of fallacies (corresponding to the three requirements on the previous
page):
1. When the requirement of relevance is not met, we have the fallacy of Irrelevant Reason, or non
sequitur.
Example: It has often been noted that the stated reasons for the US invasion of Iraq, to thwart
the use of weapons of mass destruction, has turned out to be moot, as no weapons of this
nature were found in Iraq. Donald Rumsfeld, Secretary of Defense, when asked whether he had
lied to the American people about this replied: “why do you think that the men and women in
uniform every day, when they came out of Kuwait and went into Iraq, put on chemical weapon
protective suits? Because they liked the style?”
2. When the requirement of logical sufficiency is not met, the argument commits the fallacy known
as Hasty Conclusion.
Example: Letter to Ann Landers:
My 16-year-old cousin sent for your booklet called “Teenage Sex and Ten Ways to Cool it” …
When the booklet arrived, she read it right away…Well, Ann Landers, three months later she
was pregnant and got married very fast. …What I want to know is why do you recommend
booklets if they don’t do any good?
Highly Disappointed
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3. When one or more of the premises fail to meet the requirement of logical acceptability, the
fallacy of Problematic Premise is committed.
Example: In the late 1960s, just after the release of the Beatles’ album Abbey Road, many
people argued:
Paul McCartney is dead
• There will be no more Beatles albums.
Their belief that McCartney was dead was based upon “clues” on the covers of several Beatles
albums, and maintained despite overwhelming evidence that McCartney was, in fact, still alive.
The following table summarizes this discussion of logical terms:
Word Means Can be
Statement The basic unit of logic. True or false
Argument 2 or more statements such than one or more
supports another.
Deductive or Inductive
Deductive
argument
An argument where the scope of the premises is
limited to the scope of the conclusion.
Valid or Invalid
Inductive
argument
An argument where the scope of the premises
goes beyond the scope of the conclusion
Strong or Weak
Sound An argument that is valid and has all true
premises
Very persuasive.
Fallacy An argument commonly accepted as good
reasoning despite being defective reasoning.
Seductively persuasive & often very
expensive.
Argument forms: Proving invalidity
A key point in understanding deductive arguments is to understand how validity is discerned by the
form of the argument. Proving an argument to be deductively valid is often a long and challenging
process. On the other hand, proving invalidity is sometimes much easier.
An important, and in some sense intuitive, method of proving invalidity is the counterexample
method. As you work through this section, recall that a valid argument is a deductive argument
where the conclusion must be true if the premises are true. Thus, an argument that can have true
premises and a false conclusion is invalid.
You should also remember that validity is exclusively a matter of the structure of the argument, not
the content. Any argument that has the same structure as a invalid argument is also invalid,
regardless of the truth of its premises.
Consider the following argument form,
All A are B.
All C are B.
Therefore, all A are C
This example effectively introduces the important “substitution instances” definition of invalidity: An
argument is invalid if and only if its form allows for a substitution instance having true premises and a
false conclusion.
Considering the above example, let:
A = Men, B = Mortal, and C = Cats.
Applying this substitution we get,
All men are mortal.
All cats are mortal.
Therefore, all men are cats.
Introduction to Philosophy PHIL 1200 Unit 1 13
This is a clear example of an argument in which all the premises are true and the conclusion is false.
This shows that the form of the argument is invalid
Basic valid argument forms
Propositional logic is a branch of deductive logic developed by the Stoic school of philosophers, who
flourished in Athens in the third century B.C.E., beginning about 20 years after the death of Aristotle.
The Stoic school is named after the “Painted Porch” (stoa poikile), a landmark close to their meeting
place. The Stoics’ contribution to logic was underrated in the period 200 B.C.E.-1879 C.E, which is a
long time to wait for anyone to wait for respect.
In representing these argument forms, we commonly use variables or dummy letters to stand for
COMPLETE statements or propositions—capable of being true or false when standing alone—not
only for class terms as in the Aristotelian SCS.
Here are some technical terms used in the Stoics’ propositional logic:
• A compound statement of the form ‘A and B’ (where ‘A’ and ‘B’ are both complete statements in
their own right) is called a conjunction or a conjunctive statement. Each of the simpler
statements which are parts of the conjunction is called a conjunct.
• A compound statement in the form ‘Either A or B’ is called a disjunction or a disjunctive
statement. Each of its subparts is called a disjunct.
• A disjunction may be inclusive or exclusive. It is called inclusive when it is intended to mean
“Either A or B is the case, and I’m not ruling out the possibility that both A and B are the case.” If
the intended meaning is “Either A or B, but definitely not both,” that is an exclusive disjunction.
“Either … or” in English has this regrettable ambiguity.
A compound statement of the form “If A, then B” is called a hypothetical statement or a
conditional statement. In a conditional statement, the “if”-clause (A) is called the antecedent,
and the “then”-clause (B) is called the consequent.
Here are some basic valid argument forms you will need to know. They are commonly known by
their Latin names, but we will also refer to them by reference to their structure. For instance, the
first argument form is the disjunctive syllogism, also known as denying the disjunct.
1. Disjunctive Syllogism (a disjunct) (Valid for both the inclusive and the exclusive ‘or’):
Either A or B
Not A
∴ B.
Example: I’ll either Fish or Cut Bait
I hate cutting bait
Therefore I’ll fish.
2. Modus Ponens (Affirming the Antecedent):
If A, then B
A
∴ B.
Example: If I work hard, then I can get a good grade.
I am working hard,
Therefore I will get a good grade.
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3. Modus Tollens (Denying the Consequent):
If A, then B
Not B
∴ Not A.
Example: IF I work hard then I will get a good grade.
I did not get a good grade
Therefore I did not work hard.
4. Hypothetical Syllogism (Hypothetical Chain, Conditional Chain):
If A, then B
If B, then C
∴ If A, then C.
Example: If I study then I can pass the test
If I pass the test then I can complete my degree
Therefore If I study I can complete my degree.
5. Dilemma (Valid only for the inclusive ‘or’):
Either A or B
If A, then X
If B, then Y
∴ Either X or Y.
Example: I must either walk or drive to the store
If I walk, then I will get sore feet.
If I drive, I’ll be burning expensive gas.
Therefore I’ll either have sore feet or burn expensive gas.
6. Affirming a Disjunct (Valid only for the exclusive ‘or’):
Either A or B
A
∴ Not B.
You can get academic credit for either a full term, or half term logic course (but not both).
I have credit for a full term course.
Therefore I will not get credit for a half term course.
Two common, seductive fallacies:
1. Denying the Antecedent:
If A, then B
Not A
∴ Not B.
If I pass the test then I must have studied
I did not pass the test
Therefore I did not study.
2. Affirming the Consequent:
If A, then B
B
∴ A.
If I work hard then I’ll pass the course.
I passed the course,
Therefore I worked hard.
Introduction to Philosophy PHIL 1200 Unit 1 15
The dilemma
One argument form philosophy students should study closely is the dilemma, as it is an extremely
common and powerful argument form. In ordinary English, ‘dilemma’ is often taken to be a
particularly intractable problem. In logic, the dilemma has a particular form which often presents as
a choice between two undesirable alternatives.
Form of the Dilemma:
Either A or B
If A, then X
If B, then Y
∴ Either X or Y.
Example
Either the general deliberately disobeyed his orders, or he failed to understand them. If he disobeyed
his orders, he was disloyal; and if he failed to understand them, he was stupid. Therefore, he was
either disloyal or stupid.
A = The general deliberately disobeyed his orders.
B = The general failed to understand his orders.
X = The general was disloyal.
Y = The general was stupid.
Tactics for answering a dilemma:
1. Going between the horns.
This involves denying the disjunctive premise, ‘Either A or B’. If you had evidence that the
general’s secretary was an enemy spy who changed the orders transmitted to him, you could go
between the horns of the dilemma in this example. If the disjunctive premise has the form ‘Either
A or not A’, then obviously you cannot go between the horns.
2. Grasping one of the horns.
This involves denying one of the conditional premises, ‘If A then X’ and ‘If B then Y’. One could
grasp the first horn of this dilemma by arguing that the general believed the orders came from an
unauthorized person and not from his lawful superiors. The second horn could be grasped by
arguing that the orders were unclear.
3. Charging the bull, or constructing a counter dilemma. (You must, of course, be in a position to do
this without denying something you know to be true.)
For example: Either the general deliberately disobeyed his orders, or he failed to understand
them. If he deliberately disobeyed them, they must have been unlawful; and if he failed to
understand them, they must have been unclear. Therefore, the orders were either unlawful or
unclear.
Reductio ad absurdum, or indirect proof
Another useful argument for is the reducio ad absurdum. Often called ‘reductio’ in ordinary usage.
In logic, nothing can be both true and false at the same time, so that any argument that has the
consequence of something being both true and false simultaneously is absurd.
The Form of a reductio argument is:
To prove Not S:
Assume: S.
Deduce from S either a false statement, or the contradictory of S (i.e., Not S), or a
self-contradictory statement (T and Not T).
Conclude that S must be false; hence Not S is the case.
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The Reductio ad absurdum may be regarded as an extended Modus Tollens:
If S, then (T and Not T)
Not (T and Not T)
∴ Not S.
A mathematical example
A rational number is one that can be expressed as a simple fraction, that is, as the ratio of two
integers (whole numbers). The Greek philosopher and mathematician Pythagoras (sixth century
B.C.E.) is credited with the discovery that there is no rational number whose square equals two—in
other words, that the square root of two is an irrational number. This conclusion is easily proved by
reductio ad absurdum.
Assume that there is some rational number whose square is equal to two. Let this number be
expressed in lowest terms; that is, if the numerator and denominator have a common factor greater
than one, remove it. Thus we have:
2 = (a/b)2 or a2 = 2b2
where a and b have no common factor greater than one. a2 is an even number because it is twice
b2; hence, a is an even number because the square of any odd number is odd. Since a is even, it
can be written as 2c; a2 equals 4c2. Then
4c2 = 2b2 and 2c2 = b2.
It follows that b2 is even, and so is b. We have shown that a and b are both even. This contradicts
the assumption that a/b is a rational number written in lowest terms. Therefore, there is no rational
number whose square equals two.1
In ordinary language, we often use a similar reasoning technique by referring to things that would be
absurd such as “when pigs fly”. This more common form of reductio argument relies on common
agreement as to what is absurd; when significant cultural or philosophical differences occur, it is
easy for a reductio argument to be less then persuasive.
For instance, I might argue that a logical consequence of certain changes to the medicare healthcare
system might be a ‘for profit’ healthcare system. This argument would be a persuasive reductio
argument in Canada, but would probably be much less effective in the USA.
Endnote
1 Wesley C. Salmon, Logic, 3d ed. (Englewood Cliffs, NJ: Prentice-Hall, 1984), p. 33.
Unit summary
In this unit we have provided an overview of philosophy, one that will guide you as you proceed
through this manual, and which you may want to supplement and even to criticize as your
appreciation for philosophy develops. We have also included a brief introduction to logic designed to
provide you with a conceptual framework for tackling some of the difficult theories, problems, and
concepts presented in the following pages. We suggest that you review this unit often; as your
understanding grows along with the units you study, the ideas presented in this introduction will
become clearer to you. This is especially true of the logic material. Many of the units presuppose an
understanding of elementary logic, and so your comprehension will be rewarded by a careful
attention to the logic material. However, you will find that working your way through the units will help
you with the logic material as well. In a sense, the units provide a hands-on training in logic, and so
your understanding of logic no doubt will develop as you make your way through the following
material.
Introduction to Philosophy PHIL 1200 Unit 1 17
Assignment
Look for assignment 1 located in the assignments section. Check the schedule for the due date. Be
sure to submit the honesty declaration when submitting assignment 1.
Glossary
Argument
Contradiction
Deductive
Fallacious argument
Implication
Inductive argument
Inference
Logic
Premise
Rules of inference
Statement
Sound argument
Valid argument
Supplemental readings
Bergmann, M., J. Moore, and J. Nelson. (1980). The Logic Book. New York, NY: Random House. An
advanced book for students wishing to investigate the purely formal features of argument.
Govier, Trudy. (1985). A Practical Study of Argument. Belmont, CA: Wadsworth. A good introduction
to argument that complements the discussion of the fallacies presented in the Logic Primer.
Hollis, Martin. (1985). Invitation to Philosophy. London: Basil Blackwell.
Johnson, R. H., and J. A. Blair. (1983). Logical Self-Defence. Toronto: McGraw-Hill. A nontechnical
guide to the fallacies.
Kahane, Howard. (1980). Logic and Contemporary Rhetoric. Belmont, CA: Wadsworth. An excellent
guide to the fallacies we commit in everyday argument. Numerous illustrations.
Kahane, Howard. (1982). Logic and Philosophy. Belmont, CA: Wadsworth. An introduction to
symbolic logic. Difficult for the novice philosopher but worthwhile if you are interested in
pursuing logical studies.
Taylor, A. E. (1979). Socrates. New York: Doubleday Anchor. A careful and faithful study of the great
philosopher.

Laura Wood ihuman answers

Laura Wood ihuman answers – Case: Key Findings

Key Findings

Most significant active concern: risk of breast cancer

Cystic breast disease

Overweight (BMI=27.5) with recent weight gain

American fast food diet 2 x per week

FH breast cancer mother and maternal cousin

FH of hyperlipidemia

FH of type 2 diabetes

Due for pap smear

Elevated BP 134/74

GET iHUMAN HELP HERE

Laura Wood ihuman answers Case: Key Findings Feedback

The medical problem list you have compiled should be a list that includes everything that is out of the ordinary about this patient, even when it is not a “problem” in the true sense of the word.

In a wellness visit, there may be points) of discussion raised by the patient, but by definition, there is no chief complaint, instead there may be a chief issue of concern. So the next question may be how to define the most significant active problem (MSAP)? The answer might vary, but in general the MSAP is either an issue raised by the patient or an item in health prevention that needs to be urgently addressed, for example; a 55 y/o woman who has never had a screening mammogram.

For this patient, the most significant active problem (MSAP) or issue is the patient’s risk of breast cancer and by default, the effectiveness of mammographic screening. She presents with a first degree relative (mother) diagnosed with invasive breast cancer at age 63. How does this affect the patient’s risk? How does her cousin’s diagnosis at age 44 affect her risk? How does having cystic breast disease affect her breast cancer risk or the ability of mammography to detect cancer? Does she need additional screening approaches? Does she need a genetic analysis? Finally, breast cancer risk is increased with increased exposure to estrogen. How does her age of menarche, age of first pregnancy and breast feeding affect her risk of breast cancer?

The second major medical issue is her elevated blood pressure (134/74) The AHA guidlines have changed to now classify this into the Stage 1 Hypertension category. Thus, this should be something discussed. In addition, how would her hypertension related to other FH risk factors or her body weight?

A wellness visit is also done to complete the recommended disease screening(s) so that medical problems can be identified early and addressed prior to the development of sequelae. Recommendations for screening come from; local health care systems, medical societies as well as the federal government (Centers for Disease Control, CDC) and Medicare. These guidelines are specific for the person’s gender, age, ethnicity, genetic background and family history. the patient is a 41 y/o female of Hispanic ethnicity. What medical issues are found more frequently in Hispanic women? How does her weight or body habitus affect these risks? How does her diet affect these risks?

Finally, it is important to look at her entire family history, lifestyle, diet and living location. Look at the medical problems of the patient’s parents, level of exercise, type of diet and even consider total lifetime sun exposure. What malignancies are linked to diet or sun exposure?

For the hypothesis or differential diagnosis section, instead of picking the diagnosis or medical condition (we are not diagnosing a condition, but rather we are…

Laura Wood ihuman answers Case: Problem Statement

The patient is a healthy 41-year-old G2P2 Hispanic-American female who presents for a well-woman examination. She has no active medical complaints, but is concerned about her risk of breast cancer as both her mother (age 63) and maternal first cousin (age 44) have been recently diagnosed with intraductal breast cancer. Additional risk factors include menarche age 10.5; first pregnancy age 33; she breast fed each of her two infants for only four months each. The patient, reports a normal baseline mammogram at age 40, (report not available) and a history of fibrocystic breast disease. Physical exam reveals elevated Blood pressure (134/74), increased body weight (BMI 27.5) with a FH of hypertension, hyperlipidemia (father) and type 2 diabetes (mother).

Management Plan – Laura Wood ihuman answers

The patient will be counseled regarding her. Hypertension

• Repeat the BP measurement in a week
• Reduce salt intake and try to reduce stress
• Discuss a healthy potassium rich diet and possible weight loss
• II-BP remains elevated, consider starting a low dose ACE inhibitor.

Breast Cancer Risk

• Patient has an increased breast cancer risk due to first-degree family member and early menses and late pregnancies-increased estrogen exposure to the breast tissue
• Alcohol has been associated with an increased risk of breast cancer, therefore, she is counseled to reduce her alcohol consumption as an intervention she can do to reduce her risk as well as her concern for developing this disease
• Fibrocystic disease will make self-breast examination less reliable, however, she is counseled to undergo yearly mammograms (tomosynthesis should be done if possible because of her cystic breast disease)

Cardiovascular Disease

• Screening test showed that the patient’s lipids are in the high-moderate to high range for the risk of heart disease.

This would be the time to discuss diet intervention with weight reduction and increasing vegetables and reducing fats Prediabetes

• Patient’s fasting blood glucose and hemoglobin A1C levels categorize her as a prediabetic. An improved healthy diet and weight reduction to a normal BMI can reduce her risk of progressing to diabetes. This provides an opportunity to prevent neuropathy and accelerated CAD

Lifestyle/Diet

• Increased exercise would assist in maintaining a normal BMI and would help in stress reduction

Cervical neoplasm risk

• Negative pap smear means she only needs continued screening