US Government Essays (3844 words) - , Term Papers

US Government William Jefferson Clinton William Jefferson Clinton was born on August 19, 1946, in Hope, Arkansas. His father, William J. Blythe III was killed in an automobile collision just two months before William's birth. At age four, William Jefferson Blythe IV was legally adopted by his mothers second husband, Roger Clinton, making him William Jefferson Clinton. At age 22 William received a Bachelor's degree from Georgetown University. Just five years later, he received his law degree from Yale. Soon after graduating from Yale, he became a law professor at the University of Arkansas. He did not stay in one place for long though, and in 1978 he became the Attorney General of Arkansas. From this political position, he moved higher up in the ranks and in 1978 won the election for the gubernatorial seat of Arkansas. In the 1980 elections, however, William (Bill) was defeated by Republican Frank White. As the youngest governor of Arkansas in 40 years, Bill then became the youngest ex-governor in United States history. During the interim, Clinton was hired by the law firm Wright, Lindsey and Jennings. In the 1982 elections, Mr. Clinton went after the position of governor with renewed vigor and defeated incumbent Republican Frank White. During the campaigning for the election a Time magazine article stated: "If Clinton does win, it could seem like less a comeback than a canny mid-course correction in the path of a young, bright political star." Clinton went on to win the next two gubernatorial elections in the state of Arkansas. In 1988 he had the possibility of a Democratic Party presidential nomination, but he refused to run. Finally, in 1991, Clinton announced that he was going to run for President of the United States. In the 1992 election, Bill Clinton ran against Republican incumbent George Herbert Walker Bush and independent Ross H. Perot. During the campaign, Bill met with some difficulty when the media discovered that he had dodged the Vietnam draft, been unfaithful to his spouse, and smoked marijuana while attending Oxford. Bill placated the liberal-biased media by saying that he didn't believe in the war, and he "didn't inhale." Opposition mounted when reporters discovered that Clinton and his wife, Hillary Rodham, whom he married in 1975, had made some questionable dealings over a piece of real estate referred to commonly as Whitewater. Despite the seemingly insurmountable odds, Clinton won the election, with 46% of voting Americans supporting him. Antonin Scalia, Supreme Court Justice Antonin Scalia was born March 11, 1936 in an Italian majority section of Trenton, New Jersey. His father, Eugene Scalia was a literary scholar and a professor of Romance Languages at Brooklyn College. His mother was an elementary school teacher. Scalia attended Xavier High School, a Catholic Military academy. He graduated, first in his class, in 1953. One of his good friends once said: "He was brilliant, way above everybody else." He later majored in History at Georgetown University in Washington, D.C., where he again graduated first in his class. Soon after leaving Georgetown, he enrolled in Harvard Law School, where he was known around the campus as an effective debater. From Harvard he earned an LL. B. Degree and in 1960 joined the Cleveland based law firm Jones, Day, Cockly and Reavis. He was one of the most straightforward conservatives on the staff and there too earned a reputation as a debater. Later, President Richard Nixon appointed Scalia to the position of Part-time General Counsel in Executive Office of Telecom Policy. He was confirmed by Congress under the Gerald Ford administration for the position of Assistant Attorney General in charge of the Justice Department's office of legal counsel. At that time his job was mostly to give advice to the President and the Attorney General. In 1977 he became a Professor at the University of Chicago Law School. Antonin Scalia is now an associate justice of the United States Supreme Court. He took his oath in 1986 and is the first Italian-American Supreme Court Justice. He was part of President Ronald Reagan's effort to make the judiciary system more conservative. Mr. Scalia is very outspoken against racially based affirmative action programs and the "Constitutional Right" to abortion. His views are closely related to those of the Reagan administration. Scalia is a very intelligent individual, has an elegant writing style, and has personal charm that makes him an influential member on the Supreme Court. Legislative Department The Legislative Department consists mostly of the House and the Senate, the two parts of Congress. The Senate has 100 members or two per state. The House

Dress For Sucess

Dress For Sucess Clothing is important on how others perceive us. It affects our views on our confidence and ourselves. In any business setting the most important garment for both men and women is the suit. Wearing a suit immediately conveys authority, credibility, and likeability qualities that are critical in business interactions. Different positions, companies, and different parts of the world have different dress codes. Keep in mind the importance of wearing conservative close to the office that's clean and well tailored. Throughout this speech, I will inform everyone on the correct way to dress for business.Men should wear suits that are solid colors like black, gray, or blue. Men can also wear pinstriped suits. The preferred material of the suit it wool, or polyester that looks like wool. The darker the suit, the more authority it carries.Mens shirts are also important. Shirts should be white, pale blue, or have modest strips.A man wearing a chalk-striped suitTo avoid a certain gangster look m en should avoid wearing darker shirts than their suits. This means no black shirts with black or gray suits.Men also have to wear a tie. For ties, discreet stripes, polka dots, and club ties are all right; they should never vary from the basic colors. And ties should be appropriate lengths, not to short or to long. The best length is just below the bottom of the belt buckle. The most important piece of clothing for a mens suit is a tie. But absolutely the best tie you can afford preferably silk. Another thing to keep in mind is appropriate shoes. Leather shoes are preferred. Make sure that you keep your shoes clean and scuff free. Women have to dress very conservatively for the office. This consists of a suit that has a skirt and a jacket. Pants are still too casual...

Clinical Immunology Essay Example | Topics and Well Written Essays - 500 words

Clinical Immunology - Essay Example On the other hand clinical immunology is the branch which is more important in applied medicine because it deals with those diseases which come into being due to malfunctioning of the immune system. Malfunctioning can be due to dysfunctional immune system or due to any abnormal malignant growth in the cells of immune system. The value of immunological mechanism in pathogenesis and transmission of disease is reflected in the context of prophylactic immunization or the therapeutic manipulation of immune response. These intellectual and practical considerations have created a pathway to establishment of new discipline called clinical immunology (Denman, 1981 pg.277). The diseases which cause malfunctioning of the immune system fall into two subtypes which are the autoimmune diseases and the immunodeficiency diseases. Autoimmune diseases are the ones in which our defensive immune system starts attacking are own body. Best known examples of autoimmune diseases are myasthenia gravis, Hashimoto’s thyroiditis and rheumatoid arthritis. Immunodeficiency diseases occur when the system cannot give proper response after foreign insult. Chronic granulomatous diseases are common immunodeficiency diseases. The most common and lethal immunodeficiency disorder is AIDS. Human immunodeficiency virus affects the body of the affected individual and starts competing with the normal cells of the body (Stern, 1981 pg.206). Another modern intervention the field of clinical immunology is dealing with is transplant rejection. Clinical immunologists work day in and day out to prevent transplant rejections which may occur if the host’s body rejects the tissu e that is being transplanted (Murphy, Porett and Turka, 2011 pg.39). Our immune system is our very own army. Its two arms, acquired and inate provide us with protection against internal and external insults. These insults can be lethal. With

The Rebirth of a Fallen Man Essay Example | Topics and Well Written Essays - 1500 words

The Rebirth of a Fallen Man - Essay Example The narrator undergoes externally and internally significant changes because he drugs, cares about other people, and desires to live a common lifestyle in the end of the collection (Johnson, â€Å"Jesus’ Son: Stories†). The narrator experiences positive external and physical changes as he recuperates from drug addiction. Because of drugs and alcohol, the health condition of the narrator becomes worse and worse. Before the car crash happens, the narrator cannot even stand up because a college man gives him drugs. He loses his consciousness and passes out in the grass off the exit ramp. His exhausted and weak body compels him to feel the world negatively, owing to his emotional behavior. Once, he said, â€Å"I hadn’t been anywhere near it in over a year, but I was just getting sicker. When I coughed I saw fireflies†. The aforementioned statement can be attributed with the context that the over the years, the narrator had been growing sicker, resulting in the development of chronic cough. Drug overdose during talking medications places him in a severe condition, and he is almost dead. However, things are changing...

Review of Great Leaps OR Free Rice.com Essay Example | Topics and Well Written Essays - 250 words

Review of Great Leaps OR Free Rice.com - Essay Example The site has been proven worthy by education experts because it expands education and life opportunities. The site also contains a progress charts that is very useful in tracking the performance of the learners and the instructor/teacher. The progress chart can be used for evaluation and acts as a means of motivating the learners and the teacher especially on the learning progress. Great leaps also contain sample stories. I was much more interested in the high school section. I managed to come across John Wilcox story. The story was about Wilcox who was a celebrity in his school. Despite being so famous, he lost his life to alcohol. The site provides educative and informative story depending on age. This story particularly warns teenagers on the effect of alcohol and peer influence. Most of the young people at this age are facing adolescent stage and therefore needs proper guidance and counseling which is not just a role that should be done by the teachers and the parents. Great leap s takes this opportunity to educate its users in all spheres of the life and not just books. Finally, I enjoyed the site so much and it is so interactive and informative. I would therefore recommend the use of this website as teaching and learning resource. However, the website is so expensive. I checked out some of the papers and informative materials and found out that they cost so much. This is the only disadvantage of the

Principles of Acid Base Balance

Principles of Acid Base Balance The purpose of this handout is to educate the student on basic principles of acid base balance. To give a systematic approach to interpretation and understanding of arterial blood gases and appropriate care for the patient who is having a blood gas taken. It is intended that the student will learn from this package but also be encouraged to source other material to broaden their understanding of acid base balance. It is intended that this learning packet will complement their experiences with help of an understanding mentor, who will assist them with questions raised both within themselves and within the book. An arterial blood gas measures the acidity of the blood, the levels of carbon dioxide and levels of oxygen. The blood is taken from an artery prior to the blood distributing the oxygen from blood cells to the body tissues. The values the gas will show are: Partial pressure of oxygen (PaO2) this measures the pressure of oxygen dissolved in the blood Edwards (2009) say this can indicate how good respiratory system is functioning. This can indicate oxygen saturation and how well oxygen can move from the lungs to the blood Partial pressure of carbon dioxide (PaCO2) this measures how much CO2 is dissolved in the blood and how well it can move from the blood to the lungs (and out of the body). Foxall (2008) explains that co2 mixed with water turns in to carbonic acid that the lung must excrete to prevent an acidosis. Bicarbonate (HCO3) Bicarbonate is the form in which a large amount of acid is removed from the cells Schilling (2008) says about 70% is removed from tissues and bicarbonate can be measured as either actual or standard bicarbonate. The standard which is the more important value is obtained by using a PCo2 of 5.6 kPa as a reference for the amount of CO2 in the body. Base excess (B.E.) Springhouse (2008) explains that the base excess indicates the amount of excess or lack of bicarbonate in the circulatory system it can be a negative number indicating too much acid or a positive number indicating too much base. It normal range is -2 to +2 Introduction Skinner (2005) and Adam (2009) concur in that arterial blood gas analysis is an essential part of diagnosis and management a patients ventilation therapy and their acid base balance. Skinner continues to say the usefulness of this intervention is dependent on the ability of the health professional to analyse and interpret the individual aspects of the gas. The intention of this learning packet is to introduce the learner to the individual aspects of a blood gas, and there meaning. Additionally it hopes to show how to bring these values together to formulate a decision on the patients condition and suggest options for treatment. Common reasons for blood gas analysis are: To diagnose and assess existing lung function. To review treatment for lung disease and evaluate its effectiveness. To assess if extra oxygen is required for a patient or if further support is required (CPAP, BIPAP or PPV). To measure the acid base level in patients where it is compromised. Patient would include renal patients, patient with heart failure, severe infected patients uncontrolled diabetes or individuals who have taken an overdose. Preparing the patient. Explain to the patient that they are having a blood test from their artery. It is likely to be taken from a radial artery. Nettina (2005) Describes a test to assess the puncture site prior to puncture called the Allens test procedure. This will evaluate the blood circulation in the hand and whether it is appropriate to use the radial artery for puncture. The site will be cleaned with alcohol and allergy status permitting anaesthetic agents will be applied to reduce discomfort, and increase possibility of success. Dougherty (2008) suggests that the patient should be encouraged to breathe normally through the procedure and the doctor may ask for cessation of supplementary oxygen prior, to give a better understanding of the patients present condition. After the syringe is full, place gauze over the puncture site and apply pressure until bleeding has stopped. This may be some time if the patient is on blood thinners or has coagulopathy. Once bleeding has stopped apply a dry dressing but monitor for any further bleeding. After the procedure there is a possibility of bruising although the longer pressure is kept on the puncture site the lower the risk. Some light headedness or nausea may occur during or after the blood draw. On rare occasions the needle may damage the artery or a nerve causing it to become blocked. As a result care must be taken with the wrist once blood draw has taken place. How it feels Dougherty explains that collecting arterial blood from a patient is a procedure that is often painful. It is more painful than the routine venous phlebotomy your patient may be used to. There are a number of reasons for this, arteries are often deeper than veins and surrounded by nerves. Ideally the patient is given a local anaesthetic and the patient feels just a sting as the needle punctures the skin. Otherwise there is a sharp pain as the needle enters the artery. If the procedure becomes protracted either by the practitioner having difficulty finding the artery or the artery is narrow the pain may more than brief. It is important to note that both pain and fear would cause the arteries to narrow so reassurance is important and if the practitioner continues to have difficulty you must advocate on the patients behalf since fear would impact on future successful arterial blood gas collection. Questions What other sites could a patient have blood gases taken from? Can only arterial blood be used for blood gases? What values would be markedly different in a venous sample blood gas. Why would a patient emotional response make blood draw difficult how can we reduce the affects of this to cause a positive outcome What medications or disease process would make a patients bleeding time prolonged after sampling? Further reading Royal Marsden clinical procedures manual 2008, Dougherty etal Overview The measurement of a blood gas will show a pH value. PH is a value the can range from 1 to 14 and is a measure of acidity or alkalinity of a substance. Springhouse(2008)explains in the blood stream the pH value is inversely proportional to the number of hydrogen ions in the blood. The fewer ions the higher the number (alkalosis) and vica versa, more ions would mean a lower number (acidosis). A solution with a pH of 1 is acidic and a solution of pH 13 would be alkalotic. A solution of pH 7 is called neutral since it is in the middle, it is neither acidic nor alkalotic, and water has a pH of 7. Adams (2009) explains that the normal PH of the body ranges from 7.35 to 7.45. In order for normal metabolism to take place the body must maintain this fine balance at all times. He clarifies that if the pH level rises the blood is said to be alkalotic or acidic if it drops below 7. Hall (2009) says the ability of the body to function normally is impaired if the pH moves from these parameters. Hall also concludes that in acidosis the bodys response to medication is muted, cardiac function is impaired since contractility and vascular response to catecholamines is reduced. If the patients pH is raised then oxygenation is effected which interferes with neurological and muscle function. Adams points out that severe changes in pH that is above 7.8 or below 6.8 will interfere with basic cell function and respiration and if not corrected will result in death. Below is a discussion on how the body regulates this delicate balance. We will elaborate on the processes the renal and respiratory systems use to buffer the bodys processes to keep this fine balance. The respiratory buffer system Hinds (2008) explain that carbon dioxide (CO2) is a normal by product of cellular metabolism. Carbon dioxide is carried in the blood to the lungs where excess CO2 combines with water (H2O) to form carbonic acid (H2CO2) in the blood. The blood pH will change according to the level of this acid in the blood. This fluctuation triggers either a rise or fall in respiration until the level of CO2 is returned to the patients base line. Hinds explain that this system is fairly rapid and can be triggered in a short space of time a few minutes in most cases. The renal buffer system Henessey (2007) simplifies the metabolic system explaining that the kidneys also maintain acid base balance by the excretion or retention of bicarbonate (HCO3). As the pH rises HCO3 is excreted and in return as the pH decreases HCO3 is retained. Although an effective system the renal system is slow to respond to imbalances, requiring hours or days to attend altered pH. Questions If neutral pH is 7 why does the body require a mean of 7.4 a slightly alkalotic environment to operate? The notes above indicate the bodys response to catecholamines is muted what are these and why are they important? Normal values pH 7.35 to 7.45 PO2 11 to 13.3 kPa PaCO2 4.8 to 6.0 kPa HCO3 21 to 28 mmol/l Acid Base Disorders Respiratory acidosis. Henessy (2007) discussion on respiratory acidosis is defined as a pH less than 7.35 with a Pco2 greater than 6.0 kPa. This type acidosis is caused by a build up of CO2 which combines with water in the body to produce carbonic acid thus lowering the pH of blood. Driscoll (1997) says any condition that results in a reduction in ventilation can cause this type of acidosis. Head trauma, which has inflicted damage to the respiratory centre leading to respiratory depression. Sedatives, narcotics, neuromuscular blocking agents or anaesthesia, which can cause central nervous system depression. Impaired respiratory muscle function related to spinal cord injury or neuromuscular disease. Poor lung function such pneumothorax, pneumonia, atelectasis or bronchial obstruction. Hypo inflation due to pain chest injury or abdominal distension. Hasan (2009) simplifies the presentation of the signs and symptoms of respiratory acidosis are centred within the respiratory, cardiovascular and nervous systems. These symptoms can range from shallow breathing or dyspnoea to headaches or altered consciousness and irritability. If left unchecked these symptoms deteriorate towards drowsiness and coma. Increasing ventilation support will correct this type of acidosis. The specifics of how this will be done is dependant on the mode of insult to the respiratory system. Edwards (2009) suggests ventilator support could be oxygen via a face mask, non invasive ventilation (N.I.V.) or positive pressure ventilation (P.P.V.). If medications are inhibiting respiratory function then reversal agents can be deployed whilst supporting the patients respiratory needs. Pneumothorax and pain are problems that can be reversed promptly once the patients condition allows. Marino (1997) say that if the patients symptoms or condition, cannot easily be resolved then it may be appropriate to ventilate the patient mechanically. Commonly patients with respiratory acidosis are hypo ventilating, as a result they will benefit from supplemental oxygen but this only improves the quality of respiration; it does not in fact remedy the problem. Respiratory Alkalosis Respiratory alkalosis is defined as a pH greater than 7.45 with a PaCO2 less than 4.8 kPa. Any condition that causes hyper inflation can result in respiratory alkalosis. These conditions include, Pain Anxiety fear or panic Medications which stimulate the respiratory system Lesions in the brain affecting the respiratory centre Increased metabolic demands such as fever sepsis or pregnancy. Alkalosis will present cardiovascular or central nervous system disorder. Springhouse (2008) illustrates that presentations can be dysrhythmias and palpitations to numbness and confusion. Additional symptoms are dry mouth, blurred vision and titanic spasms of the arms and legs. To resolve the alkalosis the cause of the hyper ventilation must be attended to. These patients are at risk of suddenly deteriorating, they have tachypnea and must be supported to reduce fatigue. If they become tired their own ability to ventilate adequately will be impaired leading to respiratory failure. Questions What would be the signs and symptoms of a patient with a respiratory caused imbalance? Which kind of medications can cause an acidotic condition and what would be the reversal agents? In respiratory alkalosis why do patients suffer with tetany? What are the signs and symptoms of respiratory failure? Metabolic acidosis Metabolic acidosis is defined as a bicarbonate level less than 21mEq/L with a pH of less than 7.35. Schilling (2008) explains metabolic acidosis is caused either by a deficit of base in the blood stream or an excess of acids other than CO2. Excessive bowel action such as diarrhoea and intestinal fistulas may cause decreased levels of base. Increased acids can be caused by a number of factors such as: Renal failure Diabetic ketoacidosis Anaerobic Metabolism Starvation Salicylate intoxication Hall (2009) Signs and symptoms of metabolic acidosis are varied affecting numerous systems. The nervous system presents with headaches, dizziness leading to confusion or later coma. Dysrhythmias are common as conduction pathways are affected and low blood pressure due to desensitivity to catecholamines such as epinephrine. Marino (1997) elaborates to say the respiratory system will attempt to correct imbalances by breathing out more CO2. Kussmaul respirations these are deep and laboured breaths. In the gastro intestinal tract nausea and vomiting is noted as well as warm flushed skin. The Hinds (2008) says treatment of the metabolic acidosis is to resolve the cause, this invariably means an initial review of body systems and their function. By assessing each function and its efficiency, underperfused or hypoxic tissue beds can be identified. Hypoxemia can lead to generalised anaerobic metabolism, but hypoxia of a specific tissue bed will produce metabolic acids even if oxygenation (PaO2) is normal. To reverse this acidosis perfusion must be restored which in turn will cease the anaerobic metabolism. Hinds warns that other causes of metabolic acidosis should be addressed after the possibility of hypoxia and poorly perfused tissue beds have been resolved or ruled out. Metabolic alkalosis Metabolic alkalosis is defined as a bicarbonate level of 28mEq/L with pH greater than 7.45. Metabolic alkalosis obviously is the reverse of the previous condition deriving from an excess of base or a deficit of acid. Adam (2009) suggests that excessive base comes from ingestion of antacids, excess use of bicarbonate or lactate in dialysis. Low amounts of acid come from overuse of diuretics, gastric suction or protracted vomiting. It presents through neurological signs and symptoms varying from light headedness to seizures and coma or musculoskeletal symptoms of weakness, muscle cramps and tetany. Other associated signs might be nausea and vomiting and respiratory depression. This is a relatively uncommon presentation and presents a challenge in treatment. Bicarbonate can be stimulated thought the kidneys by drugs such as Acetazolamide but it is a protracted therapy. Severe cases I.V. administration of acids may be used Questions Which other value is closely linked with the metabolic state of the body? What does it signify? What signs and symptoms would a patient show who presented with a metabolic acidosis? In a very severe alkalosis state what I.V. acids could be administered? Steps to Arterial Blood gas interpretation There are simply 3 steps to interpreting a blood gas result and each must be done in order to prevent confusion and misdiagnosing your patient. The components are pH PaCO2 and HCO3 below are three steps and following are examples to assist you in interpreting them. Step One Review the pH initially is this normal or abnormal? If the pH is above 7.45 it is alkalotic if it is below 7.35 then it is acidotic. Step Two If the blood sample pH is altered then we must consider how this is being affected. Initially assess the PaCO2 this value will move in the opposite direction to the pH when there is a insult to the respiratory system. That is as the pH falls out of normal values the PaCO2 rises from its normal limits. The reverse is true if the PaCO2 falls then the pH will rise. Step Three The third step is to assess the HCO3 value. If there is an altered metabolic function the HCO3 will alter in a similar direction to the pH. As the HCO3 value rises so will the pH and as one decreases so will the other. Examples: Using the table above and your knowledge you have gained try and diagnose the problems below. Example 1 Mr Brown is a 72 year old man admitted with recent chest infection to the assessment unit. He is quite short of breath and has a strong cough his blood gas show the following information Patient: John Brown D.O.B.01:01:38 PH 7.30 PaCO2 8 HCO3 25 Step one, assess the pH is it normal? It is not, it is low therefore it is acidotic. Step two, assess the PaCO2 is it normal? It is not, it is raised which is the opposite direction of the movement of the pH. Step three, assess the HCO3, is that normal? Yes it is within its normal range. Reviewing the grid it can be seen the pH being low, the PaCO2 raised and the HCO3 normal shows a respiratory acidosis. Example 2 Maria 29, who has a long history indigestion and reflux, has come to the drop in clinic with vomiting unresponsive to her usual medications and cramp in her hands. A routine blood gas shows the information below. Patient: Maria Goode D.O.B.: 01:01:1981 pH 7.51 PaCO2 5.5 HCO3 35 Assess the pH, is it normal? It is high indicating alkalosis Assess the PaCO2 is it normal? It is normal Assess the HCO3 is it normal? It is raised, moving in the same direction as the pH. Looking at the chart above a raised pH and a raised HCO3 would indicate a metabolic alkalosis state Discussion on compensation So far we have only looked at a simple blood gas scenarios, with only one system failing. As Hasan (2009) indicates that often if one system fails or falls out of normal range altering the pH the second system will activate and work harder to compensate to bring the pH back in to normal limits. This activity is called compensation. Foxall (2008) describes that when a patient develops an imbalance over a period of time the body will naturally attempt to compensate. The lungs and the kidneys are the primary response mechanisms and so the body will try to resolve any metabolic or respiratory imbalance to return the pH to normal There are varying degrees of compensation initially uncompensated, an altered pH with only one value out of normal range. Partially compensated blood gas, an altered pH value with both values out of normal range. Compensated blood gas, a normal pH value with possibly both values out of range. Previous examples we looked at were simple uncompensated blood gases. Now lets look at more advanced gases such as partial compensation. To review these gases as before break the interpretation down in to three simple steps Assess the pH, is the gas acidotic or alkalotic Assess the PaCO2; is the PaCO2 a normal value? As reviewed before respiratory imbalances will move the pH in the opposite direction to which the PaCO2 moves when causing a primary imbalance. If the PaCO2 is moving in the same direction that is either increasing, or decreasing in value, then this would be a compensatory behaviour and it would indicate the primary insult is coming from the kidneys (metabolic). In a compensatory environment a decreasing PaCO2 would show the lungs are buffering by excreting excess acid by blowing off Co2 in order to equalise the balance of acids and return the pH to normal. Conversely a raised pH and raised PaCO2 would indicate a buffering response by the lungs which would reduce acid excretion in an effort to return to homeostasis. In summary, if there is evidence of compensation, but the pH has not yet arrived back into normal limits then it is only partial respiratory compensation. Assess the HCO3. In our original uncompensated examples the pH and the HCO3 moved in the same direction when the primary insult was metabolic. Following our discussion above in compensatory behaviours the values will work counter to their normal presentation. So if the pH is decreasing when the HCO3 is increasing or decreasing when the pH is increasing this is a compensatory action therefore the primary insult is a respiratory one. The kidneys will hold on to or release HCO3 in response to the abnormal pH to equalise the acid in the body to return the bodys pH to normal The essential difference between these two states is that they are on a journey towards normal from possibly uncompensated , to partially compensated, to fully compensated environment (normal pH). The body is always trying to correct the imbalance however successful, but the body will never over compensate. As can be seen from the above table the pH in fully compensated states is normal. Knowing which side of 7.40 will help in determine the original imbalance that is now compensated. More technical questions Example 1 A patient enters the AE who is known to the renal team. He has been having dialysis 3 times a week for a year but missed his last appointment. He is complaining of being unwell. A Routine blood gas show the following results Using the same 3 steps we have used before: Patient : George Philip D.O.B. : 01:01:50 pH 7.31 PaCO2 3.9 HCO3 18 Is the pH normal? The answer is no it is low therefore it is acidotic Is the PaCO2 Normal? No this is also low. If the PaCO2 was causing the primary insult we would expect it to move in an opposite direction to the pH in this case it is not. We must conclude therefore that the primary insult is metabolic and the paCo2 is out of range in a compenstatory role. The lung are excreting CO2 to reduce the PaCO2 whereby return equilibrium and return the pH to normal. Is the HCO3 normal? It is not it is low moving in the same direction as the pH. Therefore confirming what has already been said that the primary problem is metabolic. If you review the tables above it can be seen that the primary problem is metabolic but the full diagnosis would be a partially compensated metabolic acidosis Example 2 A lady walks in to her local surgery complaining of shortness of breath she is a long term smoker. A routine blood gas shows the following results Patient: Jane OBrien D.O.B. : 01:01:62 pH 7.35 PaCO2 7.2 HCO3 29Assess the pH is it normal? Yes it is, but the low side of neutral Assess the PaCO2 is it normal? No it is raised an acidotic condition. If this is the primary problem we would expect the pH to move in opposite direction to the PaCO2. Assess the HCO3 is it normal? No it is also high which is representative of an alkalotic state. Although the pH is normal both elements are out of range showing there is full compensation being achieved. The pH is lower than 7.40 which shows it is moving in the opposite direction as the HCO3 which show the initial insult was respiratory and that the kidneys are compensating by retaining bicarbonate Her arterial blood gas would be interpreted as fully compensated respiratory acidosis Example 3 A 42 year old man on the surgical unit with history of bowel obstruction has had N.G. on free drainage has become unwell. Routine labs were sent and the blood gas below: Patient: Tom Jones D.O.B. : 01:01:47 pH 7.44 PaCO2 7.1 HCO3 34 Is the pH normal? Yes Raised within normal limits Is the PaCO2 normal? No this value is also raised, so therefore even if this is a fully compensated state it was a metabolic imbalance in origin. Is the HCO3 normal? No this is raised with two value out of range and the pH with in normal limits this is fully compensated gas with the pH raised in normal limits and the HCO3 raised this was an initially a metabolic alkalosis This is a fully compensated metabolic alkalosis. Example 4 David has arrived from a nursing home with altered consciousness into the AE department. His initial labs showed a raised white cell count and this blood gas was taken Patient: David Hawcroft D.O.B. : 01:01:72 pH 7.32 PaCO2 8.2 HCO3 32 Is the pH normal? No it is low therefore it is acidotic. Is the PaCO2 with in normal limits? No it is raised which indicates that respiratory system is causing the primary insult. Assess the HCO3 is that normal? No this is raised also indicating that because it is moving in an opposite direction to the pH it must be in compensation, confirming the insult is respiratory in nature. Since both elements are out of normal limits there is evidence of compensation but since thepH is not achieved normal values it is considered only partial compensation, so this gas is a partially compensated respiratory acidosis Primarily this book has been to discuss the relationship between respiratory and renal systems is maintaining the bodys acid base balance. Arterial blood gases are used also to interpret blood oxygenation using the Po2 value. This value indicates the partial pressure of oxygen, the ability of oxygen to bind to haemoglobin and transfer to tissues, this ability can be affected by the acid state of the body. Below is a discussion on the Oxyhemoglobin Dissociation Curve which is a graph that plots the behaviour of oxygen in the blood comparing saturation against partial pressure and how acid base can affect it. Oxyhemoglobin Dissociation Curve The Oxyhemoglobin curve is a tool used to show the relationship between oxygen saturation and Pao2. Marino (1997)points out that the strength at which oxygen binds to the haemoglobin can vary depending on the disease state of the body. This in turn can affect the oxygenation of tissue beds or end organ perfusion. Adam(2009) simplifies the principle explaining that oxygen can bind too tightly which would which would inhibit of transfer of oxygen to tissues that needed oxygen or alternatively not bind tightly enough an oxygen is lost before it reaches these target cells. This relationship between the affinity of oxygen and the saturation is illustrated below with the Oxyhemoglobin curve. As mentioned above there are a number of conditions or states than can affect this relationship essentially moving the graph left or right. A fever, acidosis or elevated PCo2 levels can cause reduced adhesion of the O2 molecule therefore the graph and its values appear to move to the right (A right shift). Where as if the body is alkalotic, hypothermic or a low PCo2 the graph will shift to the left which would indicate the blood is failing to release the oxygen through increased affinity The curve can be used to assess Pao2 if the oxygen saturation is known. Shown in the illustration is a person with a saturation of 82%. If the curve has not shifted then that persons Pao2 would be 51mm Hg. A value of 80mmHg could indicate hypoxemia. Correction of the patients oxygen level may be facilitated by improving oxygen delivery and resolving conditions affecting the curve. Revision Questions What number indicates extreme acid on the pH scale? What is the range for pH in the blood? The kidneys compensate for acid base imbalances by excreting what substance? Which A.B.G value indicates an excess or insufficiency of sodium bicarbonate? What two values are compared on the Oxyhemoglobin curve? Interpretation revision pH 7.33 PaCO2 8.0kPa HCO3 31 pH 7.49 PaCO2 5.9 kPa HCO3 34 pH7.37 PaCO2 5.3 kPa HCO3 25 pH 7.44 PaCO2 4.0 kPa HCO3 16 pH 7.27 paCO2 5.5 kPa HCO3 15 Further reading Mays DA (1995). Turn ABGs into childs play R.N. 58:1: 36-40 Foxall Kesley (2008) Arterial Blood Gas Analysis: an easy learning guide M K Publishing Keswick Cumbria U.K.

A Portrait of the Artist as a Young Man - The Powerful Female :: A Portrait of the Artist as a Young Man

The Powerful Female Character in Portrait of the Artist as a Young Man    One of the most powerful nuances of any writing is the dialogue within the story. In literature, it is all too often that characters live only in the jaded voice of the author and never truly develop as their own, or are not strongly opinionated in a manner which contrasts the opinions of the writer. It is also unfortunately true that the women depicted in most male-authored literature do not often sound realistic, or how most women one would speak to in the course of the day tend to sound. All too often, women are depicted on a lower level of speech than men. For instance, Dickens and Arthur Miller both apparently subscribed to this notion, as the women in their stories were usually more passive, and not as elaborate as men in their speech, however, James Joyce did not see things in the same light. The most developed female character in Joyces A Portrait of the Artist as a Young Man, is one who speaks with dignity, passion, and the female tact which is all too often ignored in the c haracters of women. Joyce's Dante Riordan's words and thoughts are true to those of literate twentieth century women.   Ã‚  Ã‚   Although a short-lived character in Portrait, Dante Riordan, in a brief amount of time emits an apparently important and mysterious aura, the aura of a woman. Judging from the studies of twentieth century linguists, Joyce's brief representation of Dante through speech is nearly flawless. To more lucidly understand this, one must carefully examine some of the instances at which Dante speaks in her conversation with Mr. and Mrs. Dedalus, Charles, and Mr. Casey, and re-examine the arguments she makes. Dante is introduced into the dinner table conversation as a silent character. However, when the men's conversation turns to the misuse of the preacher's pulpit, Dante begins her interjections.   Ã‚  Ã‚   All too often, women in literature remain linguistically dormant unless called upon, however, studies conducted in the reality outside the covers of a book have shown that women will interrupt a conversation to contradict a previous speaker, and do so vehemently (Coates, 193). A nice answer for any man calling himself a catholic to give to his priest, (Joyce, 273) states Dante as her first response.   Ã‚  Ã‚   At this point, Dante has drawn herself into the conversation.

Animal Experimentation 1

Some people think that using animals for experimentation purpose is cruel, but other people think that it is necessary for the development of science. Discuss both views and give your opinion. Give reasons for your answer and include any relevant examples from your own knowledge or experience. Animals are living beings, like humans, that also have an important role in the world. However, instead of treating the animal with love and respect, we subject it to cruel and inhumane scientific and medical experiments to further human development. What a cruel fate for the unfortunate animals, and all because of human selfishness. On the other hand, in life, as in the jungle, the concept of survival of the fittest applies, and so, as the most intelligent animal, humans are just exercising our right to dominate and use other animals as we wish. For many people the issue of using animals for science is black and white. It is either they are very pro-animal rights, or very much in favour of using animals since we are the highest-level creature. On the one hand, some people say that subjecting animals to pain and torture is truly barbaric. All animals also have feelings, thoughts, and behaviours, and so we should look after them and respect them. They may also feel that if we are so unsure about the effects of a drug, for example, then we should chemical testing before doing live, and sometimes cruel, animal testing. Others, however, believe that we must use animals for the benefit of our own species. We should use them to test drugs, cosmetics, and new developments in science, which will provide a safer and better lifestyle for us. Very few people are inherently cruel, but they still believe it is either them or us. In truth, it is better to test the drugs on a monkey rather than on a person. In my opinion, being cruel for the sake of being cruel and with no tangible results to show is definitely stepping over a boundary of acceptable behaviour. However, at other times, if the benefits of the research are explicit, tangible, and valuable, then I feel that the research is justified. Thus, whether the use of animals is right or wrong should be based on the purpose of what they are doing.

Chemistry Scavenger Hunt Clues and Answers

Chemistry Scavenger Hunt Clues and Answers One of the more popular chemistry assignments is a scavenger hunt, where students are asked to identify or bring in items that fit a description. Examples of scavenger hunt items are things like an element or a heterogeneous mixture. Are there additional items you would add to a scavenger hunt or that you have been asked to find for an assignment? Chemistry Scavenger Hunt Clues First, lets start with the clues. You can print this page out to start your own chemistry scavenger hunt or try to find the answers. These same clues plus possible answers are found at the bottom of this page. An elementA heterogeneous mixtureA homogenous mixtureA gas-liquid solutionA malleable substanceA solid-liquid solutionA substance which has a volume of 1 cm3An edible example of a physical changeAn edible example of a chemical changeA pure compound which contains ionic bondsA pure compound which contains covalent bondsA mixture that can be separated by filtrationA mixture that can be separated by some other method than filtrationA substance with a density of less than 1g/mLA substance with a density of more than oneA substance which contains a polyatomic ionAn acidA metalA non-metalAn inert gasAn alkaline earth metalImmiscible liquidsA toy which demonstrates a physical changeThe result of a chemical changeA moleA substance with tetrahedral geometryA base with a pH greater than 9A polymer Possible Scavenger Hunt Answers An element: Aluminum foil, copper wire, aluminum can, iron nameA  heterogeneous mixture: Sand and water, salt and iron filingsA homogenous mixture: Air, sugar solutionA gas-liquid solution: SodaA malleable substance: Play-doh or modeling clayA solid-liquid solution: Maybe  an amalgam of silver and mercury? This is definitely a tough one.A substance which has a volume of 1 cubic centimeter: Standard sugar cube, cut a cube of soap the proper sizeAn  edible example of a physical change: Melting  ice  creamAn edible example of a chemical change: Seltzer tablet (barely edible), candies that fizz or pop when dampA pure compound which contains  ionic bonds: SaltA pure compound which contains  covalent bonds: Sucrose or table sugarA mixture that can be separated by filtration: Fruit cocktail in syrupA mixture that can be separated by some other method than filtrationSaltwater- salt and water can be separated using  reverse osmosis  or  an ion exchange columnA substance wi th a density of less than 1g/mL: Oil, ice A substance with a density more than one: Any metal, glassA substance which contains a  polyatomic ion: Gypsum (SO42-),  Epsom  saltsAn acid: Vinegar (dilute  acetic acid),  solid citric acidA metal: Iron, aluminum, copperA non-metal: Sulfur, graphite (carbon)An inert gas: Helium in a balloon, neon in a glass tube, argon if you have access to a labAn alkaline earth metal: Calcium, magnesiumImmiscible liquids: Oil and waterA toy which demonstrates a physical change: A toy steam engineThe result of a chemical change: AshesA mole: 18 g of water, 58.5 g of salt, 55.8 g of ironA substance with tetrahedral geometry: Silicates (sand, quartz), diamondA base with a pH greater than 9: Baking sodaA polymer: A piece of plastic

Washing up liquid advert Essay Example

Washing up liquid advert Essay Example Washing up liquid advert Essay Washing up liquid advert Essay This essay is going to discuss the Fairy Aromatics washing up liquid advert. The advert is to promote the new fragrances and bottle shape that Fairy has recently introduced.  This advert does not have a narrative. Instead it just uses a series of bright, eye-catching images in modern colours to make you remember the advert, and hopefully the product too.  The advert is in three main parts, one to advertise each of the three new fragrances. The first part shows a woman with short hair in her early thirties falling back on to the petals of a giant pink flower, the same colour as the new spring fresh liquid. She breathes in the scent of the product with a relaxed and happy expression on her face, and then demonstrates the product by washing a plate, which comes out of the water sparkling and clean. The screen then cuts to the second character, a young man, who slides down a giant spiral apple. He also appears relaxed and happy, and is obviously having fun. There is then a special effect, as there is a cube rotation to link the end of this shot with the next. The last character is a young woman, this time with longer hair but approximately the same age, who is bathing under a giant lemon half. She massages her hair and appears relaxed and refreshed as she stands under the shower. At the end of the advert the screen is divided into thirds, each showing an object to represent on of the fragrances. Each third then goes through an open door rotation to reveal a bottle of the product in each of the fragrances corresponding with the object in the shot before. The shot at near the beginning of the advert where the first woman is washing up is quite realistic, although everything is very clean in comparison to how you would usually expect it to be. However, the rest of advert is quite surreal as it features people interacting with giant fruits and flowers. There are three characters used in this advert, two women and one man, each one specifically endorsing one of the new fragrances on offer. We can see from the choice of characters that Fairy is trying to appeal to a larger target audience than before. Traditionally on the Fairy adverts we see a woman with a young child, who is probably slightly older than the characters used here. Now they have chosen to include a token man in the advert as well, showing that they are attempting to include men in their new target audience. They still however show a woman actually doing the washing up rather than a man, which is quite stereotypical. The fact that they show more women in the advert rather than men shows that they still want the product to appeal more to women, as usually it is still the woman that actually goes out shopping to buy household things like washing up liquid. The chosen characters in this advert are all being used as role models for the audience. The first woman in particular seems to be the perfect housewife. Her kitchen is spotlessly clean, and her hair and make-up is done beautifully, even though she has only been cooking the dinner. When she washes the plate, it requires no effort for them to become brilliantly clean and sparkling. She has the kind of stereotypical television lifestyle that many people would love to have. As people want to be like her, they will also want the things she has, like the washing up liquid. When she washes the plate, the light focuses on this rather than her, as it shows the wonderful result the product has achieved, and draws your attention to it. Throughout the shots she appears in, her facial expression always shows confidence and relaxation. When she falls back on to the flower she closes her eyes and her body language is open as her arms are held out away from her body. This shows her confidence, and also shows she is relaxed in this situation. Her expression also shows hints of luxury as she falls on to the petals. In this shot the light is focused on her face so these feelings are conveyed to the audience. The next shot, the close up on her face, helps to reinforce these messages. The next character, the man, also shows an expression of confidence and happiness. Again, his body language is open as he holds his arms up and out to the sides as he slides down the apple with the camera tracking him. As the shot changes from the first woman to him, the music also changes slightly, but not dramatically. A guitar is added into the instruments already used, which gives it a slightly more masculine sound to the melody. It also adds a more fresh sound to the music as the focus changes from the floral fragrance to the apple one. It is subtle but helps the scenes flow smoothly from one to another. To make the next transition smooth, a cube rotation is used to link to the next scene of the woman bathing under the lemon half. The camera starts focused on the lemon, but then tilts down to a medium shot of the womans face. She appears relaxed and refreshed as she massages her hair under the shower, and the light focuses on her face. The camera then cuts to a shot looking up at her from below. This makes her seem like a role model, as she appears higher up than the audience and you are looking up to her example and how relaxed and happy she looks from buying this product.  All three of the characters appear happy to be associated with the washing up liquid. The bright, modern colours used in the advert, with the young characters make the advert appealing to the younger audience. The advert attempts to make washing up seem cool at a time when there is so much competition with dishwashers.

The Fifth Replies of Descartes Essay Example | Topics and Well Written Essays - 1000 words

The Fifth Replies of Descartes - Essay Example The Fifth Replies of Descartes The argument in question is the argument of Discourse. The problem with this counter argument is the inherent bias. There is a premise and theres a conclusion if one accepts the premise the conclusion must be accepted. Renà ©e Descartes says that he knows he exists it is inherent that he knows what he is and what his nature is, it is the very definition of establishing his existence. This knowledge (of existing) cannot be separated from the knowledge of what that existence is about. This point can be elaborated through an example for instance one sees a bottle of water. His eyes tell him that it is there. Since this person has the premise that what his eyes see is in fact real (or existing) it means that he knows that the bottle exists. When he say that it exists it means it has certain properties that indicate that it exists. No one can say that something exists without acknowledging the properties. Existence without the knowledge of its properties is even more illogical than deriving a conclusion that existence of self also encompasses the nature of self. When Renà © Descartes say that he thinks therefore he exists, it means that he is aware of what he is and what his nature is. Otherwise there is no existence. Every existence has its properties; be it divine authority like God or as trivial as a plastic water bottle. The objection of Descartes’s claim rests with the understanding of premise. If the critics accept the premise when Renà ©e says that something exists, he also bases this by understanding some properties.

Dissertation Example | Topics and Well Written Essays - 12500 words

Dissertation Example This study suggests that the explanation as to how information systems contribute to the performance and competitive advantage of the firm may lie within the specific responses, and competitive actions that the firm participates in or the role information systems play in the competitive dynamics of the firm (Eisenhardt 2004). Kenya and most African countries have one thing in common; they all have a large health provision gap, which is growing each year. This provision gap is prevalent mostly in the urban areas. This arises due to rural-urban migration since young men, and women move to urban areas in search of employment. This movement to urban areas has led to the over stretching of the available and limited health facilities. Due to this, many dispensing chemists that at times act as clinics have sprung up in almost every estate, surburb in the city. The health provision gap can be supplemented through such dispensing chemists and pharmacies. Moreover, many households cannot affor d to pay medical bills at the hospitals and see this as a cheaper way of meeting their medical needs. Capital Chemist is one of those dispensing chemists that operate within Nairobi with the aim of making medical supplies such as drugs, and equipment readily and cheaply available. It also offers services such as laboratory tests. It aims to support and reduce the health gap that exists in Kenya, especially the urban areas. Capital Chemist has over 50 employees and has been operating in the pharmacy market in the country for the last 5 years. Its drug dispensing division is one of the most profitable of the overall venture. Despite increasing competition from other dispensing chemists and pharmacies, Capital has maintained a strong position in the drug dispensing market thanks to its attractive, long operating hours, and the variety of drugs and medical equipment it offers. Even though the popularity of Capitals’ long working hours and a variety of services, Capital has manage d to keep and attract more customers due to the strong customer relationship it has. It has also been able to achieve this through its high level of customer support. 1.1 BACKGROUND OF THE STUDY The Capital Chemist, herein referred to as ‘The Chemist’ is a pharmaceuticals drugs and medical equipment retail chain in Nairobi, Kenya. A registered pharmaceutical retail company was incorporated in 2007. It has branches in several parts of the city. Its presence manifests itself in almost every estate, in the city. Administratively the chemist is served through all its 12 branches across the city. It has its headquarters in Nairobi’s Central Business District. These branches aim at meeting the goals, and mission of the company. All operations are regulated and controlled by the headquarters in Nairobi. It aims at providing quality, readily available medical drugs to its client when needed and whenever needed. Synchronizing the management and operations of these branche s to ensure efficiency in service delivery, and profitability has become a nightmare. Currently each of the 12 branches has its own management system that is limited to point-of sale management only. The other process such as inventory management, price control, and diagnosis are manually handled using spreadsheets. Given that daily sales and purchase quantities are high and are forecast to increase, tracking and