Cardiac Catheterization

Cardiac catheterization is often referred to as coronary angiography or a coronary angiogram. It is a radiographic procedure that is used to look at and visualize the heart and the coronary arteries. During a cardiac catheterization it is possible for the cardiologist performing the procedure to see how effectively blood is flowing through the coronary arteries. In addition, this procedure allows the cardiologists to see how blood is moving through the chambers of the heart and how effective the heart valves are functioning. A cardiac catheterization can also allow for the visualization of the movement of the walls of the heart to see if the pumping action of the heart is normal. The primary application of cardiac catheterization is to determine if there is the presence of coronary artery disease. If there is occlusion of the coronary arteries this is the result of atherosclerosis, or plaque build up within the coronary arteries. During a cardiac catheterization it is possible for the physician to identify the location and size of these plaque deposits. The presence of plaque within the coronary arteries can lead to a myocardial infarction; therefore, if the plaque buildup is substantial, therapeutic action has to be taken. This treatment may include coronary bypass surgery if the coronary artery disease is widespread and or the arteries are occluded to a large degree. A large number of patients who do have coronary artery disease are treated in the cardiac cath lab during the catheterization with procedures such as percutaneous coronary intervention (PCI) and angioplasty with stenting and artherectomy. Angioplasty is performed by inserting a catheter into the coronary artery that is blocked. The catheter has balloon that can be inflated where the blockage is present. The pressure from the inflated balloon will force the plaque to the sides of the coronary artery. This will allow the artery to open and allow for increased blood flow through that branch of the coronary arteries. Once the plaque is moved aside the cardiologist will insert a tiny expandable wire tube known as a stent. The stent will be placed where it can be expanded to hold the artery open. Some stents are designed to simply keep the artery held open. Other stents used are drug-eluting stents. These stents are coated with pharmacologic agents that work to prevent restenosis of the artery. Another form of PCI is artherectomy. This is a procedure that has a cardiologist using a cutting blade that spins rapidly or a laser beam to cut away or burn away plaque that is blocking a branch of the coronary arteries. To perform a cardiac catheterization the patient is brought to the cardiac catheterization lab. These procedures are performed by specially trained cardiologists, nurses and radiologic technologists. The procedure is performed on a specialized table with fluoroscopy equipment, cardiac monitoring equipment, and the use of computerized technology to assist in data and image collection and analysis. To perform a cardiac catheterization the cardiologist will insert a sheath, or a short tube usually into the femoral artery. A long very thin catheter will then be fed through the sheath and guided through the arteries until it is in the heart and coronary arteries. The physician uses fluoroscopy equipment to guide the catheter into the coronary arteries. To allow for clear viewing of the coronary arteries, contrast material is injected into the catheter. As the contrast material flows through the heart chambers and coronary arteries x-rays are taken. The physician can than visualize the heart, valve function, and the flow through the coronary arteries. Any obstructions in the coronaries will become readily visible. The contrast material used to allow for the visualization of blood flow is iodine based and is flushed through the patients system rather quickly once the test is completed. The contrast material will be injected into the catheter that has been fed into the heart. As the contrast material flows through the heart x-rays are taken as a motion picture. This allows the cardiologist to not only visualize the flow of blood through the heart and coronary arteries, but the wall motion and valve function can be seen as well. This component of a cardiac catheterization is the actual coronary angiogram. If there is coronary artery disease, which is a blockage in some branch or branches of the coronary arteries, these blockages will be visible during the angiogram. The cardiologist performing the procedure will then determine the course of therapy to enhance blood flow through the coronaries. In mild cases, the patients may be treated medically with no cardiac catheterization intervention. In more severe cases the cardiologist might perform angioplasty with stenting. In those cases where stent placement cannot be done, or if the coronary artery disease is too widespread, then coronary artery bypass surgery might be warranted. A cardiac catheterization generally takes about 30 minutes. It can take longer if the cardiologist has to perform angioplasty and place multiple stents. Following the procedure the patient may remain in the hospital overnight or they may be able to go home after a few hours of recovery time. Most cardiac catheterizations are done via catheter insertion into the femoral artery. When the procedure is completed the sheath will be removed and the entry site will be closed with the application of pressure and a suture device or plug. A cardiac catheterization is an invasive procedure done in a sterile O. R. like environment. Although, the complications are rare, they do exist. Complications include: Allergic reaction to the contrast material, irregular heart rhythm, bleeding where the catheter was removed, infection, coronary artery spasm or acute closure, a tear and bleeding, and the need for emergency heart surgery. However, the benefits far out weigh the risks. The clinical information that this gold standard test provides about the heart, and the ability to open coronary arteries without surgery makes this procedure critical for those who are believed to have heart disease.

English Written Task Essay

Prescribed question: How and why is a social group represented in a particular way? Title of the text for analysis: Things Fall Apart, Chinua Achebe Part of the course to which the task refers: Part 3: Literature – text and context Key Points: †¢ Define masculinity in Okonkwo’s viewpoint †¢ Explore how Okonkwo never shows his emotions because of fear †¢ Describe the struggle of Okonkwo’s strength †¢ Discuss the importance of Okonkwo’s reputation of Umuofia †¢ Explain why Okonkwo emphasized on his masculinity Critical Response In Chinua Achebe’s novel, Things Fall Apart, interpretations of masculinity were challenged. Masculinity commonly means the characteristics related to men. Okonkwo, a strong wrestler and leader, had his own attributes of what manliness was. According to Okonkwo’s definition of masculinity, men were presented as strong. Anything that did not demonstrate strength was considered as weak, which was not in his definition of masculinity. While masculinity meant having qualities of a man, Okonkwo was represented to show how he perceived a man truly defined through the factor of fear and why he displayed manliness in this approach. Okonkwo was afraid of showing emotions, because revealing any sentiments showed flaws. Okonkwo liked Ikemefuna and treated him as if he was his own son. However, Okonkwo did not show any emotions towards Ikemefuna. He thought showing affection was a sign of weakness. Due to his fear of imperfection, Okonkwo felt the emotions inwardly. The only real emotion he ever brought to life was anger. â€Å"The only thing worth demonstrating was strength.† (Achebe, 1994, p. 28) Showing emotions such as happiness or sadness was a portrayal of tenderness, which Okonkwo hated. If Okonkwo showed any emotion at all, it would be evidence that he was weak. In one scenario, Okonkwo had to choose his reputation of a strong male authority or his devotion to Ikemefuna, the one he thought of to be his son. This huge struggle to prove Okonkwo’s strength was questioned when he was forced to kill Ikemefuna. Okonkwo killed Ikemefuna when Ogbuefi Ezeudu ordered him to not touch the boy. (Achebe, 1994, p. 57) The man cleared his throat, drew up and raised his machete, Okonkwo looked away. He heard the blow. He heard Ikemefuna cry ‘my father, they have killed me!’ as he ran towards him. Dazed with fear, Okonkwo drew his machete and cut him down. He was afraid of being thought weak. (Achebe, 1994, p. 61) Okonkwo was afraid people would think that if he did not kill Ikemefuna, whom he loved, he would seem weak. His character to show others that he was not weak was a greater importance than his attachment for the boy. He wanted to be brave and keep his reputation as a wrestler and a leader of Umuofia. There was one instance that Okonkwo went against his definition of being manly. This showed the vulnerability of Okonkwo, which showed why he was afraid of being weak. Okonkwo became depressed after the death of Ikemefuna. He did not sleep and did not eat any food. (Achebe, 1994, p. 63) Okonkwo was compared to a â€Å"shivering old woman,† (Achebe, 1994, p. 65) showing that only woman showed their emotions. If a man could not get over the death of someone he loves, he was nothing more than a woman, who was generally the one that mourned the death of another. Being depressed over a death was a sign of gentleness, which Okonkwo did not desire. Shivering implies weakness because when people shiver, they shake, are unstable, and are not usually strong enough to hold themselves together. So, Okonkwo could not control himself in this situation. It also showed fear and a loss of composure, two things that a man should never express. The use of the word ‘old’ also showed how fragile he was becoming in this instance. It was a similar idea when Okonkwo thought he was old because old people in general were weak; as people get older, their heart and muscles were degenerated, so the quality was not durable. There was a reason why Okonkwo emphasized his masculinity. Okonkwo’s father, Unoka, was poor, weak, lazy, a failure and a coward. Unoka was in a lot of debt. He loved gentleness and idleness. He did not like the sight of blood. (Achebe, 1994, p. 6) In contrast, Okonkwo entered upon to be strong and hardworking, not wanting to be gentle or idle. The strong wrestler was not scared of blood at any moment, showing he was a strong individual that can deal with death of others. (Achebe, 1994, p. 67) From then on, Okonkwo wanted to show Umuofia that he was not similar to his father in any way; he wanted to be better than his father because he did not want to be known as a son of a borrower who did not give money back to the lender. As a result, Okonkwo worked to not be a failure like his father. He changed how he behaved as a man to be successful. (Achebe, 1994, p. 4) Okonkwo worked hard to have a title in Umuofia and to supply money for his family. Masculinity was shown in the fear of weakness because Okonkwo represented masculinity through his behavior. Masculinity was depicted in Okwonko’s fear of weakness. In some parts of this novel, Achebe showed the reader the wrong ways to be a man by showing what was weak, causing the readers to believe the complete opposite of how a man should truly act. Okonkwo was afraid of being weak because it would directly contradict his idea of how he should act as a man. He strived for strength and power. By showing his aversion of weakness to the readers, it gave Okonkwo’s definition of masculinity. Okonkwo viewed masculinity as strength, bravery, successful, and feelings of anger. Works Cited Achebe, C. (1994). Things fall apart. New York: Anchor Books.

California Space Heaters

New line of invented, convection, kerosene space heaters Due to high energy prices In the ass, the units were expected to do well The target market was aimed at low Income consumers who had electric heating systems – especially In the east Also would be used by those consumers who had their heat shut off 1) Is this heater a socially useful product? Should it be produced at all? Yes, based on the incremental benefits of existing heating mechanisms, the space heater is a socially useful product.More cost efficient, enabled heat to be focused where needed eliminating unnecessary waste In rooms where heat wasn't needed, and could enable certain demographics to have heat where they otherwise wouldn't (due to high energy prices). 2) under what legal standards will consumer In]rules be dealt with? Liability lawsuits were probable should there be injuries or adverse health consequences. Strict liability in tort would in all likelihood be the applicable liability standard, so the compa ny could be held liable even if an injury were due to reasonable misuse by a consumer.Total costs would include the cost of liability insurance, legal and court costs, and the time of management required by the cases. Insurance costs could be reduced by adding safety features. 3) What framework should the company use to make decisions about which product safety features to add? Given that framework, which particular product safety features should they add? The company should weigh the costs of the bare bones option of the space heater.From here determine the costs and benefits of adding subsequent safety features while incorporating the likelihood of harmful effects based on the data that they have. Electric spark ignition should clearly be incorporated given that it reduced the likelihood of death by an estimated 50%. 4) Should the company offer a line of products with various safety features/price combinations from which customers can choose? How should the product be priced? Ther e should be one consistent, standard safety level that the company should strive o achieve.By implementing different safety levels, the company runs a large risk of legal risk of future penalties and the final price should have an optimal balance between cost of parts and labor vs. future liability. 1) What were the underlying cases of the spill? 2) Evaluate the political and economic logic of the $20 billion fund from both President Obama and BSP point of view. 3) Should the U. S. Government change the way that it regulates this industry? Implement policies that minimize risk California Space Heaters There is a fine line between how much safety a corporation should provide to the consumer regarding its products vs. how much responsibility of safety should fall on the average consumer. Take, for instance, the all too familiar McDonald’s coffee episode. Does McDonald’s have a responsibility to its customers to ensure the coffee isn’t hot enough to scald if spilled upon one’s lap? Or should the customer be held responsible for their own safety in regards to common sense judgment? This is what California Space Heaters, Inc. CSH) must consider when deciding exactly which products to launch. Kerosene heaters are often times used in shops and garages as well as inside homes. They are quite a bit heavier than standard electric space heaters, which tip over easily. Because of their weight (and low center of gravity with fuel), kerosene heaters are typically very sturdy. Tipping over a kerosene heater takes some doing. Additionally, because there is fuel involve d, people are probably more cautious than they might be with an electric heater. Users have the responsibility to use extreme caution when operating any fuel-based component, especially any type of heating device. Due to the stability of these types of heaters, a corporation should not be held liable for recklessness that results in a kerosene heater tip-over. Using these arguments, I would recommend that CSH does not incorporate an automatic cut-off when tipped over on any of its units. Instead, one of the most important features that should be implemented is an electric spark ignition. The first danger of no electric start option is simply the repetitive lighting of a match. While it is the users’ responsibility handling matches safely in their own home, a combustible fuel is also involved, which increases danger significantly. According to CSH engineers, adding an electric start option would decrease the probability of death by 50%. Even though the cost of the feature is relatively high at $19. 50, the risk of death is simply too high to ignore. A corporation that has been given such estimates from its engineering department has a responsibility to implement a safety device. Electric start is the single most important ption that should be incorporated on all models for safety reasons. The profile of users in a shop or garage setting differs greatly from users in a home. Users in a shop or garage are more likely to be mechanically inclined. Additionally, safety features are arguably more important in a home than in a shop or garage. In a home, the heater is typically closer to combustibles, including furniture, curtains, and carpet. Due to these v ariables, CSH should market an indoor/outdoor heater and an outdoor only heater. The only necessary option on the outdoor heater is the electric start, as previously discussed. A shop or garage user will likely be more mechanically inclined and able to adjust the wick accurately. A thermostat shouldn’t be needed because the unit will less likely be near combustibles. Overheating due to flare-ups will not be as big of an issue either because of the surroundings, not to mention the user is more likely to notice flare-ups because the unit will only be operating when he or she is in the garage or shop, in most cases. A removable tank would also not be necessary since fill-up is easier outdoors. On the other hand, the indoor/outdoor heater should have three options incorporated on the base model. The first is the electric start option, as mentioned previously. The second most important option is the wick stop. This option keeps users from lowering the wick too much, which causes inefficiency and increased emissions. The average home user is probably less likely to know how to operate the wick for ideal combustion. And because the unit is operating indoors, emission control is much more important than it is in a garage or shop where there is more ventilation. The third and last option absolutely necessary for the indoor heater is a removable tank. Refueling a tank indoors is dirty, aromatic, and more dangerous than refueling outdoors. A removable tank also eliminates the need for a siphoning system. A tank level gauge is just a â€Å"bell and whistle† not needed for a base model. An electric wick adjustment is an option that could be implemented on higher-end models, but is not a big safety concern, so does not justify the high cost. For both indoor and outdoor heaters, it would be very important to apply warning labels in clear view on the kerosene heater in regards to asphyxiation, proper wick adjustment methods, re-fueling methods, and other pertinent safety information. The cost of the basic heater without any safety options is $44. To add the electric ignition for the outdoor model, the cost would be $63. 50. Adding the wick stop and removable tank to the indoor model, the cost would be $76. With an average of a 95% markup for retail, the outdoor unit would sell for about $124. The indoor unit would sell for about $144. 50. The safety features implemented for these base models do three things. First of all, they address basic safety concerns that are considered (at least in part by the engineers) to be relatively dangerous to the average user. Secondly, by keeping the safety features to a minimum and including only the options deemed pertinent to safety, it keeps the price as low as possible, while maintaining corporate responsibility. And lastly, by implementing these features (though few), insurance premiums per unit should drop from the estimated $55 per unit. In conclusion, corporations have a responsibility to provide reasonably safe products, but consumers must also use common sense judgment and take responsibility for their own actions. By introducing these base model products as suggested, sales shouldn’t lag far behind the estimated 2,000,000 units annually; and on top of that, the units can be something CSH can proudly produce knowing that safety precautions have been provided to customers. Oh, and my view on the McDonald’s coffee case? Whether the coffee was 100 or 200 degrees, the customer who spilled the coffee was solely to blame.

Freedom Rider Essay Example | Topics and Well Written Essays - 500 words

Freedom Rider - Essay Example It may be that we are in poverty- after all, we were once slaves. Our ancestors left us with no riches to inherit and no lands to claim but their legacy remains skin deep: our freedom to voice out what we feel and think. This legacy has been brought about by the history of our people who have been burdened by issues such as slavery and persecution and yet we have chosen to rise from our conditions. Our history has made us strong and persevering in the face of obstacles and in times of crises. All these we inherited from our ancestors and with all these attributes that I have called into mind, I ask you not to fear for my life in my participation of the freedom rides. Like our ancestors, I am strong, I will persevere, I shall rise above our prejudiced conditions, for the main reason that I want to voice out what I feel and think is right. Being a â€Å"freedom rider† is a paradox of some sort. As you might know already, we will be riding interstate buses into the segregated southern United States. I assure you that we’re not riding with the flow of current events, that is, were not just riding on the issue about segregation in the south just to get mileage. Instead, what we really aim to do is to challenge the status quo of having racially segregated waiting rooms and terminals. Though we know that we face arrest by authorities and possible attacks from mobs, we choose to fight back with non-violence and willful determination. We choose not just to go above our social conditions such as racial bias and injustice, but we choose to be above those who have fought with much bloodshed and violence, precisely because we have freedom. We are free to choose our goals and our means to achieve those goals, and we choose to be peaceful just like many who have come before us. This is a learning experience for me as it is a learning experience for our society. Our very ways will show society that the end doesn’t necessarily justify the means. On my part, I hope to realize

Minimum wage Article Example | Topics and Well Written Essays - 750 words

Minimum wage - Article Example If the growth in minimum wages had been at par with the growth in average Wages, minimum wages in America would have been $10.50 today. Moreover, if they had been concurrent with ‘productivity,’ then the minimum wages should have been $18.75 and if it had grown at the same rate as the upper 1% wage paid to workers, the minimum wage would have been $28 per hour today. (Cooper and Hall) There are many returns associated with increasing the minimum wages. Firstly, contrary to many who believe that increasing minimum wages creates unemployment in the economy, it actually creates more employment. Secondly, an increase in minimum wages would give more money in the hands of the workers, which would mean extra spending in the economy. According to the economic analysis done by Cooper & Hall (2013), they say that a â€Å"$115,000 increase in economic activity results in the creation of one new full-time-equivalent job in the current economy.† (Cooper and Hall). Considering this analysis, they conclude that an increase in minimum wage from the current levels to $10.10 an hour would result in extra employment opportunities of about 140,000 new workers. However, Jacob Mincer (1974) believed that there was no real evidence to suggest that an increase in minimum wages would lead to unemployment or create employment. (Mincer). Currently, for each job opportunity in the US, there is an unemployment of approximately 3.4 (Shierholz cited by Cooper and Hall). This is because the employers do not have to offer the adequate wages to employ a worker, nor do they have to increase wages to retain the worker. Cooper and Hall quote American Enterprise Institute scholar Desmond Lachman, a former managing director at Salomon Smith Barney, as told to The New York Times, â€Å"Corporations are taking huge advantage of the slack in the labour market—they are in a very strong position and workers are in a very weak position.

Powers and limitations given to those in our government Essay

Powers and limitations given to those in our government - Essay Example First and foremost, the legislative along with the executive branch would be heavily involved. The legislative branch would pass legislations to facilitate and address this issue with the collaboration of the President. In this matter, the judicial branch would act last because it serves as a last resort to conflict that occurs within government Lobbying and interest groups are pinnacle of a force that dictates policies and legislations. In political markets, the benefits of a policy may not be readily determined. Lobbying is extremely influential as interest groups and lobbyists can push legislation through congress. Lobbyists are strong and organized. Moreover, they have networks that expand in the white house that allows them to give strong message to the public. With the public behind them, officials are induced to pass legislations. As the current president, President Obama can push much vital legislation that can dramatically address this issue. First and foremost, he can create tax breaks for these corporations in order to facilitate the corporation’s losses. Moreover, he can push legislation that will lower tariffs in oil imports and exports. Furthermore, the logistics industry can get government funding in order to help them in this economic crunch. The Congress can pass hedge bills to facilitate gas and logistic companies. The government can give subsidiary compensation to trucking companies just like they help the farmers. Reducing fuel surcharges to the truckers would tremendously help them also. Truckers can also deduct unexpected losses from their personal income taxes and businesses which can facilitate the process. Supreme court can use reviews to analyze the regulations passed by Congress in order to evaluate if it is unconstitutional law. It has done that previously with cases such as Brown vs Board of Education and Plessy vs Ferguson. The Supreme Court in essence dictates the assurance of

The Chrysanthemums Assignment Example | Topics and Well Written Essays - 250 words

The Chrysanthemums - Assignment Example This is evident on her passion to pursue a life of adventure, on the road, like the tinker who came up her house one day. Her sexual needs are also mentioned in the story, having shared a flirtatious banter with the tinker and even kneeling in front of him like â€Å"a fawning dog†. It should be noted that Elisa doesn’t have kids and she was already 35, which signals that she and her husband Hank do not really have a productive, if at all, sexual relationship. The story ended with Elisa crying because she knew that she would be forever kept in that â€Å"closed pot† of a valley. The conflict of the story is character vs. society. This is set in 1938 and the women are not as privileged as men. Even though we see that Elisa is smarter and better than the two men, she is still confined to the house, tending flowers instead of doing something more productive. She finds this frustrating, and this is not her fault, it’s the society’s. Her happiness and se lf-fulfillment is being regulated by the society and it’s suffocating her. The theme is also gender inequality. We see this story as a good reflection of society in that day, and Elisa symbolizes the women as much as the two male characters symbolize the men. However great a woman can be, she is still relegated to doing house work, just because of her sex.

The Education of Professionals Research Proposal

The Education of Professionals - Research Proposal Example According to Hall [(1968) as cited by Fertig (2003)], professionalism can be associated with the performance of the professional in his or her most individual capacity. Hall (1968) identified the role of the professional academic as embodying a belief in serving the public and a sense of autonomy and commitment towards his or her respective profession. This view is also shared by Engel (1970) who regarded professionalism amongst academics as focussing on individuality in the actions and the decision-making process. Exworthy & Halford (1999) have stressed the impact of tighter accountability control within Higher Education particularly for the professionals within the HE sector in order to achieve efficiency [as cited by Fertig (2003)]. In this vein, this paper explores how this has affected the concept of professionalism in Higher Education. The Changing Meaning of Professionals and Professionalism It is true to a large extent that the modern notions of professionals and professionalism have changed considerably due to the changing notions of these concepts over time. As stated in Fertig (2003), Robson (1998) and Harper (2000) share the view that there is a pronounced trend of professional management within the Higher Education sector in England where a distinction can be drawn with and the 'professional' paradigms There is also a pronounced trend of specialization within the professions which is reflected in the way the modern courses and teaching are structured.. This is demonstrated by Koehn (1994:150) for whom professional ethics are â€Å"an institutionalized expression of prevailing public morality†. Abbott (1988) has argued that professionalism and higher professional education share a deep bond. Ethics and Professionalism The problem of ethics within the education of the professions comes in where there is a problem of â€Å"specialization† providing the ability to ask for high fees and higher rewards which some academics have sought to pacify as necessary for the public interest (Abbott, 1988).

The Case for Torture Essay Example | Topics and Well Written Essays - 500 words

The Case for Torture - Essay Example Similar scenario is drawn about a bomb on a jet with hundreds of passenger’s lives at stake and unless information about the bomb is made available, the bomb will explode and kill thousands. Another scenario asked a few mothers if torture is justified for a person who has kidnapped their baby. The logic and reasoning used by Levine is that false sense of ethics should be set aside when the lives of innocent people are at stake. His further justification is that in most cases, victims of terrorist’s attacks are innocent people who have done nothing to offend a terrorist. They just happened to be in the wrong place at the wrong time. On the other hand, the criminal carries out pre mediated terror attacks for profit or to fulfill some religious zeal. In any case, the terrorist is willing to die in his attempt. In such an instance, law enforcers should keep aside their false sense of ethics and torture the criminal to extract a confession that will save lives. On first reading, the essay of Levine seems logical and his arguments sensible. If torture and pain can extract and yield information that helps to save lives, then it should be done. However, one is not sure if torture will work on suicidal terrorists who are ready to blow themselves for a religious cause. Assuming torture is applied and the criminal dies from the pain, then the only lead available is wasted. Modern medicines and truth serums help to obtain the required information without torture. This method is used regularly to extract the deepest hidden information from criminals and terrorists. There is always the fear that an indoctrinated terrorist will continue to tell lies even under torture. Another very serious point is as to who will decide when torture is justified and if there is any graded procedure that can be used. If police officers and investigating officers decide that they feel torture is justified

Essay convincing students of the benefits of studying abroad - 1

Convincing students of the benefits of studying abroad - Essay Example Students get to interact with the locals on a daily basis and through this they learn and experience the culture of the host society. They learn new customs, traditions, foods, social conventions, beliefs, and values, experiencing the cultures in depth. With the new experience, students learn to appreciate their culture and the new culture. Interacting with new cultures make the students break cultural barriers they had before. Being in a foreign country, offers students the chance to visit tourist attractions such as museums, landmarks and natural wonders in the host country. Studying abroad provides an opportunity to learn a foreign language. Students often learn foreign languages in classrooms while in their countries and rarely get to practice it in real life settings. Learning abroad provides the environment to improve one’s language skills. As students interact with peers, they practice and perfect their skills regarding the foreign language (McKeown 42). Written language sometimes differs from the spoken language, being immersed in the culture, they have firsthand experience even learning slang, which is not taught in the classroom. Different countries have varied styles of education. The same concepts that students study may be expressed in a new style that is different from their country of origin. When student from different backgrounds study together, they discover new ways to study and research. Ideas they share are from diverse perspectives, influenced by varied experiences and cultures. Their discussions have a global perspective, avoiding bias influenced by one way of life. Global problems influenced by differences in cultures and religions are understood and addressed with informed sensitivity Students abroad find themselves alone, often for the first time, in a foreign country. They have new found freedom and responsibility. Studying

Assessments and children Essay Example | Topics and Well Written Essays - 250 words

Assessments and children - Essay Example Teachers in early childhood education should be very committed, as children require extra care and the teacher should be very attentive to ensure that the children really understand what they have learnt in class. Additionally, the teacher should be ready to communicate as he or she has to inform parents about the progress of their children, has to communicate with children to ensure that they understand, and has to report to the school management (Childcare Education Institute Para. 1-7). Teachers use several tools to assess the progress of the pupils and one assessing tool used is a review and reflection tool. This tool assesses and reflects on the progress the knowledge that children have acquired in class and enables the teacher to come with strategies to handle each child. The advantage of this assessment tool is that it makes children to be keen on the things learnt in class and promotes the relationship between the teacher and the child. Additionally, there are high expectations of children understanding the lessons learnt in class through reflections (Flottman, Stewart, and Collette 6-12). In conclusion, early childhood education has been vital in molding children about life and the teachers in early childhood education should be committed and use the right tools to ensure that children understand things learnt in class. Flottman Rachel, Stewart Lucinda and Collette Tayler. Practice Principle 7: Assessment for Learning and Development. 2011. Web. 28 Jan. 2014.

Final Exam - Latest Essay Example for Free

Final Exam Latest Essay 1) When a manager makes use of a SWOT analysis, one of his or her objectives is to 2) 2) A company that wants to distinguish itself from the competition in the marketplace is most likely using which of the following strategies? 3) 3) An organization’s ________ goals are official statements of what an organization says its goals are. 4) 4) When planning for unexpected events, a company is using which of the following techniques? 5) 5) The ________ determines the number of levels and managers in an organization. 6) 6) Which of the following is a characteristic of an organic organization? 7) Which of the following is a characteristic of a matrix organization? 8) Searching for new ideas beyond an organization’s boundaries and allowing changes to easily transfer inward and outward is known as ________. 9) Which of the following stages is when the group structure is in place and accepted by the group members? 10) Conflicts can be resolved by satisfying one’s own needs at the expense of others. This conflict- management technique is known as ________. 11) Which of the following statements is true about group decision making? 12) According to the Ohio State studies, which of the following dimensions of leader behavior refers to the extent to which a leader is likely to define and structure his or her role and the roles of group members to meet goals? 13) Which leadership theory is derived from the belief that a leader’s job is to remove pitfalls and roadblocks so followers can achieve their work goals? 14) If Carol Reece is a charismatic leader, which of the following characteristics is she most likely to possess? 15) Indira Patel has been working in her organization’s computer security department for the past 10Â  years. If another employee follows Indira’s recommendations in a given situation, based on her expertise in computer security, which source of power is Indira using? 16) Melvin manages a team of 10 employees, including Jane and Jared. Jared is leaving the organization to find a job as a manager in another field. Meanwhile, due to performance issues, Melvin terminates Jane’s employment with the company. Both of these are examples of what type of employee behavior? 17) Thomas often annoys his coworkers with his talkativeness and assertive personality. According to the Big Five Model of personality, Thomas would be described as high in the trait of 18) Kelly is interviewing candidates to fill a vacancy on her team. One candidate has a degree from a prestigious university, and Kelly is impressed. In speaking with her fellow members of the interview panel, however, Kelly finds that no one else enjoyed the interview with the candidate, finding her to be pompous, aggressive, and self-serving. In her focus on only the candidate’s education, Kelly may have fallen victim to 19) It is crucial to determine an acceptable _____ during the comparing step in the control process. 20) If a manager rationalizes that he or she does not have time to investigate the source of a problem and instead resorts to putting out fires, the manager is missing the use of 21) Why are feedforward controls more rarely implemented as compared to other types of controls?

Engaged In The Retail Stores Operation Management Essay

Engaged In The Retail Stores Operation Management Essay In the beginning in 1962, Wal-Mart founder, Sam Walton, who opened the companys first discount store in Rogers, Ark. In October 1969, Wal-Mart officially incorporated its business and operates over 4150 retail facilities globally. At the year of 1962, Wal-Mart has its competitors- KMart and Target. Walton studied his competitors and borrowed liberally. In the United States, Wal-Mart is the largest retail store. It mainly has its retail store in Canada, Mexico, and the United Kingdom. (Walmart Corporate, 2012) Throughout the United States, Wal-Mart is engaged in the retail stores operation. Wal-Mart is most practicing mode of entry which is wholly-owned subsidiary and joint ventures globally currently. In China, Wal-Mart is practicing joint venture and acquisition entry modes (Hornblower, 2004). Wal-Mart needs to be careful in choosing the appropriate strategy in order to develop the future expansion successfully. Wal-Mart operate its business is because it wants to save people money tend to help them live better. It continues to deliver that promise to families around the globe. Therefore, Wal-Mart works harder to do their part in protecting our planet and conserving our natural resources (Walmart Corporate, 2012). Joint Venture is an entry strategy for a single target country in which the partners share ownership of a newly created business entity (Warren Mark, 2011). This means that Wal-Mart joint venture with local partner and local parent earn more than 51 percent share attributed to Chinas government policy. Through joint venture, Wal-Mart may able to share the risk with the local partner and it can limit financial risk as well in 1996 (Wal-Marts Strategies in China, 2005). Wal-Mart joint venture expands their strategy in order to gain successful entry into many of its international markets (Marcus, Jon, Wayne, and Constince, 2007). Wal-Mart may able to gain access, increase profitability, enhance global market share and explore into more global market (Gary and Ryan, n.d.). However, Wal-Mart may enter the new market quickly, avoiding costs and risks of new product development, gaining market share and acquiring new knowledge and capabilities. In 2007, Wal-Mart successfully acquired Trust-Mart. Wal-Mart has been established the brand name of Trust-Mart (David, 2007). Current Expansion Strategy Joint Ventures and Acquisition in China Today, Wal-Mart is one of the leading international retailers in China. It is also one of the largest international retailers in China. It is estimated that the firm will have 150,000 employees in its stores and warehouses in China alone by 2010. China is the largest emerging market, and Wal-Mart could expand their business rapidly. Wal-Mart has followed much of this expansion in China through joint ventures because of government restricted foreign retailer not to own a store. Therefore, Wal-Mart followed government policy strictly (DePamphilis, 2009). Learning about a market through a joint venture is a particularly powerful motivator when a firm seeks to enter an emerging or developing market. When Wal-Mart entered China, partnered with local firms in the new cities, tend to enter to learn about their challenging environment and distribution system (Jim, 2004). The nature of China is that the culture and political power can vary widely from one major city to another. Hence, joint ventures in such situations allow Wal-Mart to learn about the local system, such as legal standards, consumer characteristics, labor markets, and building relationships with the government and local distributors (Hornblower, 2004). China is the cheapest workshop and emerging market in Asia, so it would like to attract Wal-Mart to invest in its country. Wal-Mart tend to enter the emerging market is because it operates on a smaller scale in new market before making a more significant investment. Apart from that, Wal-Mart divides the responsibilities and liabilities with others to keep a minimum cost. It also combines assets and skill-sets with other companies. (Wal-Mart Store Inc., 2010 Annual Report) China could offer the opportunity to foreign firm operated with no taxes on foreign business for the first few years of operation. Therefore, Wal-Mart caught a chance and tends to expand their business into China. (Hornblower, 2004) One of the reason Wal-Mart expand their business to China because the impact of competition and the restriction and lowered the market trade barrier caused U.S operation could not control attributable to the faster growth of Wal-Mart. Moreover, due to China has the strong economic growth and it has 1.3 billion population of people and also cheap labor they could provide. It would compete with Carrefour, Tesco and Metro more easily because China removed all limits on business location, amount and share structure. Therefore, Wal-Mart endeavors to gain a better marker share in Chinas $240 billion retail market. (Wal-Mart Bulks up China Expansion Strategy, 2005) Wal-Mart entered China through this entry mode is successfully. China could offer a way of getting around high Chinese tariffs, allowing a company to gain a competitive price advantage over imports. (Philip, Mary and John, 2009) China government has provided Wal-Mart the benefits of synergy which the local partner providing the access to the Government officials and market information besides sharing the risk. Acording to (Gerald and Edwin, 2008), sales and profits of the joint venture may be greater than those of a subsidiary, because the operation is looked upon with more favor by nationalist-oriented consumers than would be the case if it were considered a foreign operation. Therefore, Wal-Mart could be sustained its growth and sales will be increased through this joint venture. Stern and Stalk (1998) found that the expansion in China has been proven Wal-Mart could reduce stock-carrying and transportation costs and increase profitability by 2.5 percent compared with their competitors. However, through the joint venture with local partners, Wal-Mart is able to gain valuable knowledge on Chinese market, economic and political conditions. Joint Ventures are really a good option for their expansion since Chinas government regulated the foreign retailers enters China market should use joint venture strategy. This could allow Wal-Mart apply the valuable resource to improve market, economic as well as political condition (Clem, 2009). There is also an acquisition Trust-Mart in China which bought 35 percent of its shares. Trust-Mart is one of the leading retailers in Chinese market. Wal-Mart is willing to acquire and invest huge amount of capital because Trust-Mart has several number of stores. In addition, Trust-Mart also is leading position in China. This could enable Wal-Mart to capture much more competitive advantages in China. (Lee, 2011) Indeed, Wal-Marts retail footprint could become doubled where taking full control of Trust-Mart. At the same time, China tends to develop its economy sustainably in promoting the domestic consumption (David, 2007). This acquisition helped Trust-Mart expand on the Chinese mainland. Nowaday, it had more than 100 retail outlets in 34 cities on the mainland and employed more than 30,000 employees (Li, 2011). Wal-Mart planned to acquire the rest of the Trust-Mart, but the plan has been delayed because of several top executive resigned in 2010. This caused to Wal-Mart unable to acquire Trust-Mart the rest of the share (Li, 2011). Through this acquisition, Wal-Marts sale is less than 3 percent of its sales in America (Walmart v Wumart, 2011). Future Expansion Strategy According to Bishop (2006), a firms entry mode is how to enter the foreign market, and how to make its goods or services available to foreign customers. Basically, there are six different modes for a multinational firm to choose, such as licensing, exporting, turnkey project, joint venture, franchising and wholly-owned subsidiary (Hill, 2004). The current entry mode of Wal-Mart in China is through joint venture with Shenzhen International Trust Investment Co., Ltd, China due to the government restriction on foreign ownership. But joint venture benefits Wal-Mart from knowledge of the host countrys competitive conditions, political systems, language, culture, and business system. However, joint venture could bring negative effect to Wal-Mart because it has a risk of giving control its technology to its partner when it entry into a joint venture and it would also caused to conflict happen when the shared ownership arrangement is different and the goals and objectives is change. Hence, it is important for Wal-Mart to convert its entire joint venture stores into wholly-owned subsidiary. In order to completely convert into wholly-owned firm, the very first step that Wal-Mart should take into consideration is acquiring its partner Trust-mart. By acquisition, Wal-Mart is able to reduce risk over losing control and tighten control over operation in country and by the way maximize the profits. It is possible for Wal-Mart to acquire Trust-mart because China had lighten the limitations towards foreign company after joining WTO in year 2001 and after so many years operation in China, Wal-Mart is know well about the cultures and customer preferences in that country. At the same time, the large number of stores and leading position of Trust-mart in China makes the strong attraction for Wal-Mart to acquire. Undoubtedly, this acquisition would help Wal-Mart to capture more competitive advantage in China. The successful role models of acquisition that can be benchmark by Wal-Mart were the acquisition done by it in Canada and European countries. The company entering Canada by acquiring 122 Woolco stores in 1994. Due to continuously suffering a loss in Canadian operation, Wal-Mart quickly restructured the operation by applying the practices that had been successful in United States and the action taken was profitable. And the acquisition made in Germany and United Kingdom in year 1998 and 1999 also proved to be successful where it allowed Wal-Mart to build market share quickly within the highly developed and competitive European market. (Source: Wal-Mart takes on the world) Besides that, Wal-Mart should also build up a partnership or joint venture with local supplier in near future to ensure the flexibility, freshness of the foods and understand more about customers needs and tastes. It is because the strategy adopted in United States may not be fitted in China. The Chinese consumers are more prefer to consume fresh food rather than frozen food. A good example can be follow is Carrefour; it did a great job on building partnership and direct sourcing agreement with local suppliers. It focuses on locally sourced products, especially regarding fresh food. It also rely them to distribute goods directly to stores. A greater emphasis on partnerships with farmers enables Carrefour to have better control over food quality, and to reduce buying costs.   Finally, it proved to be more flexible to customers than any others do. Additionally, joint venture with local suppliers and purchase locally not only create flexible to customers, at the same time also reduce the costs in development than having joint venture with Investment Company. As deeply understand of the customers around, local suppliers have more experiences about the customers which are more accurately than foreign companies. Lastly, another future expansion that would recommend to Wal-Mart is through mergers. According to Valentine (n.d.), successful mergers businesses are reaping benefits and gain more profits. Therefore, a merger with Trust-mart and any other giant company in China may help Wal-Mart to obtain quality staffs and knowledge or additional skills to cope with different in culture and customer preference. Apart from this, merging also provide Wal-Mart the opportunity to increase market share and expand to new geographical areas and sectors. The best evidence to illustrate was Carrefour making its first merging with NextMart Shanghai store after entering the China retail market for more than ten years. This movement had marked a basic change in their expansion strategy and indicated the second climax of Carrefour expansion in China. (Sources ¼Ã… ¡www.China-cbn.com, 2007) Wholly-owned subsidiary in Philippine We would like to recommend Wal-Mart to expand their operation in Philippine. Philippine is one of the richest and developing countries in Asia. We suggest Wal-Mart using wholly owned subsidiary. This is because under the Retail Trade liberalization Act (RA 8762), this law indicates that foreigners may own up to 100 percent of a store with pad-in capital of the Peso equivalent of USD $7.5 million. This mean that Wal-Mart could paid up capitalization of USD $7.5, wholly own a firm in Philippine (Abigail, 2011). It is more suitable using wholly-owned subsidiary which is acquired a Philippines local firm. According to Philip et al. (2009), wholly-owned subsidiary could develop its operation with a greater control and higher profit compare with other entry mode strategy. However, this strategy has a higher risk. In another word, higher risk will get high return. Besides that, through the wholly-owned subsidiary, Wal-Mart could also state-of-the art technology hence resulting in increased operational efficiency. Wal-Mart could offer control over the local firm. In addition, Wal-Mart has its wholly-owned operations in Canada, Brazil and Argentina, there are extremely successful since Wal-Mart has past experience operate in these Country. For instance, Wal-Mart successfully became a wholly owned subsidiary in Japan, Seiyu recent year. (Walmart Corporate, 2012). Wal-Mart could learn the strategy same as in Japan because Wal-Mart has its experience and knowledge to use this entry mode into Japan. Wal-Mart can form a new firm or find a local company to do the business. By doing this way, Wal-Mart could earn a valuable knowledge from local partner since they operated in Philippine several years because they know the economic, government policy, consumer buying pattern and consumer purchasing power (Gerald and Edwin, 2008). For instance, David and Gary (2010) found that Wal-Mart often acquires ongoing firm as they move into a new market. Wal-Marts 2005 acquisition of controlling interest in the Central American Retail Holding Company helped Wal-Mart acquire valuable knowledge about this important market. Retail trade in Philippine is very vital and essential in order to boom the economy. Thus, Philippines government encourage foreign retail to invest in their country. In view of the fact that Wal-Mart is giving the low price of the retail grocery service for Pilipino, this would more satisfy them to buy Wal-Marts products (Retailing in the Philippines, 2002). The reason we recommend for Wal-Mart to expand in Philippine due to Philippine is an open economy which is freely and business-friendly economy. Government also gives multinational company some incentives such as tax exemptions and tax and duty-free importation of particular materials and equipment. Aside from tax and government incentive, Philippine has a strategic business location which suitable for European and American businesses to operate their business there (Why do business in the Philippines, n.d.). Joint venture in Malaysia Furthermore, as many foreign retailers looked forward to invest in Malaysia because of the purchasing power of local consumers, we recommend that Wal-Mart can expand their business in Malaysia in the future. However, Malaysia has restricted and controlled the foreign hypermarkets to expand and enter to the local market in order to protect smaller local businesses over recent years. But some of the major foreign retailers such as Carrefour, Tesco, Giant, and Isetan have operated and doing well in Malaysia. Wal-Mart can try to enter Malaysias market because the entry of foreign giant retailer would bring benefit for both parties including the profit for Wal-Mart itself, and at the same time create job opportunities for the local workers. Furthermore, other than create job opportunities; the entry of Wal-Mart will also make the retail market more competitive and simultaneously benefit consumers by providing additional place to shop. Moreover, we recommend Wal-Mart to apply joint venture as the entry mode into Malaysia retail market. Wal-Mart can try to joint venture with the local giant enterprise such as Berjaya Group, YTL, and IOI Corporation. However, Wal-Mart normally applies acquisition to enter into the countries. Unfortunately, Malaysia government has restricted and tightly controlled the entry of foreign retailers. Before that, Wal-Mart has tried to enter into Malaysia but have been rejected because the government realizes that the entry of Wal-Mart into Malaysia will greatly affect the local retailers. Moreover, Wal-Mart is able to provide the goods to the customers at a very low price because its business model is very efficient, but the low price of Wal-Mart has threaten the small local retailers as they may not able to fight the lower price with Wal-Mart and their business will be greatly affected, at the same time unable to survive. The reason we recommend Wal-Mart to expand by using joint venture in Malaysia is because the minister of Malaysia stressed that Wal-Mart is not allowed to operate new retail stores or hypermarkets at their own discretion. However, according to Vivian (2007), Malaysian authority was planning to loosen the limitations on foreign hypermarket so as to attract foreign direct investment in Malaysia retail market. Therefore, Wal-mart might have an opportunity to expand into Malaysia. In order to successfully enter into Malaysia, Wal-Mart should joint venture with Berjaya Group to open a new store named as Berjaya-Mart as Berjaya Group is one of the successful companies. Through joint venture, Berjaya-Mart is able to access larger markets because Berjaya Group provides larger geographical markets and customer bases. Furthermore, Berjaya-Mart is new to the market and may need to spend a lot and the process is complicated. Through joint venture can helps to overcome some of the problems such a s government regulation, direct financial losses, operating complexity, and reduce the cost of entry. Moreover, start a business in a new country might confront with political factors and the strict rules and regulations by the national government. Joint venture will help Berjaya-Mart to penetrate into the local market in Malaysia. Conclusion In conclusion, China is always an attractive market among countries for foreign investment. Although the retail market in China has a great potential, but the competition is very fierce from both local Chinese retailers and foreign retailers. However, Wal-Mart was a well-known company which with high reputation in global. Wal-Mart will continue to success in the future in China is mostly depend on the future expansion and their market strategy. As mentioned above, other than joint venture, we were recommended that Wal-Mart can try to use wholly-owned subsidiaries, partnerships, and merger. The wholly-owned subsidiaries from both acquisition and Greenfield investment will create advantage and help to expand in the future. Acquisition helps Wal-Mart to access and enter foreign market quickly and a way to achieve greater market power. Wal-Mart applies acquisition to achieve the larger market power to consent to exercise of a core competency and capture competitive advantage in global ma rket. Although it is high risk due the potential high cost, but it is the most probable to provide above average return. However, for partnerships is somewhat easy to establish, Wal-Mart able to get fresh products much more easily through partnership with the local suppliers. Partnerships can help Wal-Mart to save cost as each partner specializes in certain aspects of their business. Undoubtedly, more and more foreign investment including Wal-Mart has come into China, and they usually bring advanced technologies and also management knowledge. Moreover, some of these foreign entrants are successful in the worldwide. Expansion of Wal-Mart in China is one of the successful examples of foreign investment and can be learned by other firms. However, some business models which successful in other countries may not be successful in China. In order to success in China, both internal resources and external environment are critically important for Wal-Mart. Moreover, Wal-Mart can be so successful today in worldwide, there must a reason behind, which is Wal-Mart able to implement monitoring measures consistently in their operations and performances of their employees and managers that sent to China. Furthermore, Americans culture and Chineses culture is greatly different, but Wal-Mart is able to adapt speedily to the Chinese culture, fulfill requirements while carrying out their responsibilities, and get appreciation of the exclusive processes of doing business in China. However, there is also a lot space for further improvement of Wal-Marts strategies and future expansion.

Effectiveness of Social Model of Health

Effectiveness of Social Model of Health Anna Wei Models of Health Health is one of the most vital and valuable aspects of human life, as without one’s health we are unable to enjoy our day-to-day activities and have the energy to pursue physical activities. There are two well-known models of Health and Illness that focus on different aspects of health; they are the Biomedical model and the Social model. This essay will discuss the relevance of the Social model in today’s society as opposed to the Biomedical model and the effectiveness of this model in clarifying the obesity epidemic, a medical condition that is dominating the globe and bringing with it many other illnesses that today, are some of the leading causes of death. The Biomedical model believes that biological factors are the main cause of disease (Browne, 2005). It has been the main model for health care in the past century, due to its assistance in the discovery of countless medical advancements as it was able to decrease the amount of infectious diseases such as tuberculosis (Borrell-Carrio, Suchman Epstein, 2004). This framework is based on the concept of health as being without disease and focuses on finding cures that will successfully eliminate the biological factors that caused the illness (Cleland Cotton, 2011). Although the Biomedical model has been valuable in the discovery of many techniques to successfully treat numerous diseases, it is no longer the dominating model of health in today’s society. This model has been scrutinised for being too narrow-minded resulting in its inability to analyse different forms of sickness (Borrell-Carrio et al., 2004; Cockerham, 2007). Over the years, there have been massive health reforms, from infectious diseases such as puerperal fever, gonorrhoea, malaria and scurvy to the dominating chronic illnesses that affect society today such as obesity, cardiovascular disease and diabetes (Tulchinsky Varavikova, 2000). The transition from infectious to chronic illnesses indicates that as time changes, strategies that have previously worked may not be as effective as they had once been. Hence, the social models were introduced. A psychiatrist named George Engel first proposed the Social model, as he wanted to put a stop to the dehumanisation of the practice of medicine, and to give patients the power over their own health (Borrell-Carrio et al., 2004). Engel believed, that the social and physiological aspects of an individual played an important role in relation to the illness procedure and hence, this model acts as an aid, to guide us through the numerous levels of organisation that affect diseases, ranging from the social aspects to factors at the molecular level (Alonso, 2004; Borrell-Carrio et al., 2004). Since Engel first proposed this model, there have been many variations of this model created such as the Dahlgren and Whitehead’s model of health and the WHO social determinants of health framework. Social models place a strong emphasis on not only the biological aspects of disease but also the social and the psychological aspects of sickness, whereas, the Biomedical model is built around the evidence and the symptoms of the disease of interest (Brown, 2005; Cleland Cotton, 2011). Hence, Social models of health have become more relevant over the last 150 years because of the changing society. As time passed, infectious diseases were no longer the major problem, with the problem now lying within the degenerative diseases such as cancer and heart disease present in today’s society (Cleland Cotton, 2011). Therefore, the Biomedical model is no longer relevant as the development of these non-communicable diseases is multi-factorial and hence is not due to straightforward biological causes, nor can they be cured easily (Cleland Cotton, 2011). For people in society today, the experience of suffering from a disease is not just about the biochemical processes behind it, but als o about how the patients identify with this disease in terms of the things they are able to or unable to do, their emotions and the unmet requirements as a result of this disease (Jackson, Antonucci Brown, 2003). Hence, Social models are more widely accepted and relevant in society, as it recognises the multi-factorial causes associated with diseases such as obesity. Obesity is defined as the extreme build-up of fat due to energy input being greater than energy expenditure, in technical terms, a body mass index (BMI) of 30 or over means that the individual will be considered obese (World Health Organization [WHO], 2014). The rates of obesity have been rapidly increasing since the 1980s and not only the prevalence of obesity has been increasing but the incidence of diseases associated with obesity has also been increasing (Finkelstein, Ruhm Kosa, 2005). Health consequences associated with obesity are non-communicable diseases such as cardiovascular disease, cancer, diabetes and other musculoskeletal diseases (WHO, 2014). The obesity epidemic is a major issue in society today and in 2008, of the 1.4 billion adults considered overweight, over 200 million males and nearly 300 million females were considered obese (WHO, 2014). In the early twentieth century, obesity was only thought to be present in developing countries such as China, Thailand and Mexico and only affected those with higher socioeconomic positions in the population; however, this disease has shifted to affect those of lower socioeconomic position and globally, there is now more than 10% of the world’s population of adults considered obese (Callabero, 2007; WHO, 2014). The improvement in people’s living and working conditions has resulted in society having longer life spans due to the eradication of infectious diseases (Cockerham, 2007). However, the major issue facing society today is non-communicable diseases such as strokes, heart disease and cancer which all stem off obesity (Cockerham, 2007). Non-communicable diseases were originally thought to affect only the rich, but there is now an increasing trend in developing countries. If this trend continues to increase at the same pace, it is estimated by the year 2020, for every ten deaths, seven will be due to non-communicable diseases (Boutayeb, 2006). This transition from infectious diseases to chronic illnesses meant that the use of medicine became increasingly important in order to tackle these health issues and therefore, there has been little success in tackling these non-communicable diseases as the approaches they took in the past via the Biomedical model proves to be unfitting for t he current situation (Cockerham, 2007). Social models have been effective in preventing this problem, as it takes into account not only the biological causes of these health conditions associated with obesity, but also social factors such as dietary intake and physical activity. An individual’s lifestyle is vital towards their health as it is a relevant social mechanism that needs to be considered when approaching these diseases (Cockerham, 2007). Over the years, the dietary intake of individuals has increased, with people consuming more sweetened beverages and processed meals and consuming less healthy wholesome foods such as fruits and vegetables (Callabero, 2007). Research reveals an inversely proportional relationship exists between the availability of fast food outlets and the socioeconomic status of the individual, with individuals in lower socioeconomic areas being 2.5 times more exposed to fast food chains compared to those in higher socioeconomic areas, and this social gradient indicates that a decreasing s ocioeconomic status results in an increased chance of obesity (Reidpath, Burns, Garrard, Mahoney Townsend, 2002). This brings about inequality between those of low socioeconomic status and those with high socioeconomic status, further reiterating that there must be other factors apart from biological components, which bring about diseases. Physical activity has also decreased with people opting for more sedentary lifestyles, for example, it was predicted that less than 30 percent of the US population had a suitable level of exercise, another 30 percent were involved in physical activity but not enough, while the remainder had adapted to sedentary lifestyles (Callabero, 2007). It is habits such as these that has attributed to the individual’s susceptibility or resistance to these illnesses (Cockerham, 2007). Only Social models of health can take into consideration of these habits as well as the social gradients shown to help us to understand their influences towards these ill nesses that stem off obesity. Many complex factors are interacting with one another, causing the increase in prevalence of health conditions associated with obesity (Candib, 2007). Therefore, Social models are effective in explaining this phenomenon as it recognises the importance of social factors and how they contribute to health conditions such as cardiovascular disease. Social factors such as the individual’s surrounding environment can either reverse or increase the biological risk of diseases making the Biomedical model inadequate as it does not consider anything but the biological cause (Cockerham, 2007). An environment that has contributed hugely to this increasing prevalence is an obesogenic environment; this is essentially a setting that encourages sedentary lifestyles; promoting food consumption and discouraging exercise, which eventually leads to an increased risk of obesity (Reidpath et al., 2002). Social models are therefore efficient as it considers how we can eliminate such influences in or der to reduce the multi-factorial effects associated with the obesity epidemic by combining the formerly separated characteristics of illness (Cleland Cotton, 2011; Jackson et al., 2003). It helps us to efficiently comprehend the significant contributions of multiple factors outside the biological sense that drives the increasing prevalence of health conditions associated with obesity. To conclude, health is one of the most important aspects of human life and can be affected by factors that are not always biological components. As a result, the multidimensional Social models were created to allow a better understanding of the diseases, such as obesity, that affect our society (Borrell-Cario et al., 2004). However, because society is constantly changing – there is no perfect model for health that exists and therefore we must seek new ideas that we can incorporate in our models with the hopes that it will be applicable to the changing society. Reference List Alonso, Y. (2004). The biopsychosocial model in medical research: the evolution of the health concept over the last two decades.Patient education and counseling,53(2), 239-244. doi: 10.1016/S0738-3991(03)00146-0 Browne, K. (2005). Health and Illness. An introduction to sociology, 3, 397-415. Retrieved from http://www.library.auckland.ac.nz.ezproxy.auckland.ac.nz/ereserves/2144315b.pdf Borrell-Carrio, F., Suchman, A. L., Epstein, R. M. (2004). The Biopsychosocial Model 25 Years Later: Principles, Practice, and Scientific Inquiry. Annals of Family Medicine, 2(6), 576-582. Retrieved from http://www.annfammed.org.ezproxy.auckland.ac.nz/content/2/6/576.full.pdf Boutayeb, A. (2006). The double burden of communicable and non-communicable diseases in developing countries.Transactions of the Royal society of Tropical Medicine and Hygiene,100(3), 191-199. Retrieved from http://trstmh.oxfordjournals.org.ezproxy.auckland.ac.nz/content/100/3/191.full Callabero, B. (2007). The Global Epidemic of Obesity: An Overview. Epidemiological Review, 29, 1-5. doi: 10.1093/epirev/mxm012 Cleland, J., Cotton, P. (Eds.). (2011).Health, Behaviour and Society: Clinical Medicine in Context. SAGE. Retrieved from http://books.google.co.nz/books?hl=enlr=id=BuZpuJSlNRMCoi=fndpg=PP2dq=Jennifer+Cleland,+Philip+Cotton.+(2011).+Health,+Behaviour+and+Society:+Clinical+Medicine+in+Context.+ots=CSbguqMTZlsig=TvNhB4GJdQnp8m-enuFPer6J2Qg#v=onepageq=modelf=false Cockerham, W.C. (2007). The social causation of health and disease. Social causes of health and disease, 1-24. Retrieved from http://www.library.auckland.ac.nz.ezproxy.auckland.ac.nz/ereserves/2130941b.pdf Finkelstein, E. A., Ruhm, C. J., Kosa, K. M. (2005). Economic causes and consequences of obesity.Annu. Rev. Public Health,26, 239-257. doi: 10.1146/annurev.publhealth.26.021304.144628 Jackson, J. J., Antonucci, T. C., Brown, E. (2003). A cultural lens on biopsychosocial models of aging.Advances in cell aging and gerontology,15, 221-241. Retrieved from http://books.google.co.nz/books?hl=enlr=id=kBXLPaaXPKcCoi=fndpg=PA221dq=%22biopsychosocial+models+of+health%22ots=ToNciaJ7sosig=fZmma3Fai9VhqZm5xhCPS1oEy_w#v=onepageq=%22biopsychosocial%20models%20of%20health%22f=false James, P. T., Leach, R., Kalamara, E., Shayeghi, M. (2001). The worldwide obesity epidemic.Obesity research,9(S11), 228S-233S. Retrieved from http://onlinelibrary.wiley.com.ezproxy.auckland.ac.nz/doi/10.1038/oby.2001.123/full Reidpath, D., Burns C., Garrard J., Mahoney, M., Townsend, M. (2002). An ecological study of the relationship between social and environmental determinants of obesity. Health and Place, 8, 141-145. doi: 10.1016/S1353-8292(01)00028-4 Tulchinsky, T. H., Varavikova, E. A. (2000). The New Public Health: an introduction for the 21st Century. San Diego: Academic Press. World Health Organization. (2014). Obesity and Overweight. Retrieved from http://www.who.int/mediacentre/factsheets/fs311/en/ 1

Reefer Madness Essay -- essays research papers

I. Introduction and Overview   Ã‚  Ã‚  Ã‚  Ã‚  There is something very interesting about a book with a cover promising lurid tales of sex, drugs, and cheap labor. The persona of Eric Schlosser's subject and the effective marketing behind it are very verbose in nature. Here in this book, Eric Schlosser is keeping with the long tradition of the so called, â€Å"yellow† journalism, in wresting the black market, from the back alleys of public consciousness and putting it on display in the storefront of the eye of everyone. In the painfully, yet enjoyable essays, Eric Schlosser takes us on many numerous excursions through the war on marijuana, the lives of immigrant farm workers, and the very dirty sex industry in the United States. He paints a very graphic image of hypocrisy in the policies of the U.S. government by examining the power of the economy of the underground and the misuse of government resources in legislating morality to its public. . II. Major Issues In each of the authors essays in this book, is the truth of the smut and other things of the American ideal. You could say it is a liitle bit Weber's Protestant Ethic meets Larry Flynt. In each scenario, whether through agricultural facility and personal liberties, in the case of marijuana criminalization; immigrants in search of a better life, in the case of stigmatized farm workers; or punishing a successful businessman because of his lack of morals, Eric Schlosser returns to the unpleasant image of America as a bundle of hypocrisies.   Ã‚  Ã‚  Ã‚  Ã‚  On one level, each scenario is of an American archetype of success. For a country that prides itself on its immigrant history, hard-work ethic, and financial success stories, it seems strange to make these folks look like the villains. This is what Eric Schlosser is getting at: that these people would be heroes if the American ideal were anything more than a myth. Forgotten in that ideal, rationalized somehow, is the fact that our national heritage also includes a strong grounding in Puritanical morality somewhat. This is perhaps one of the most dissatisfying aspects of Schlosser's book, that the exploration of our moral grounding is never explored all that deeply, even though it is criticized. However, it is indisputable that the author, Schlosser, feels that the American ideal has a dangerous and powerful hold on the public co... ...ese topics, or is he attempting to establish himself as a liberal?   Ã‚  Ã‚  Ã‚  Ã‚  Perhaps, ironically, Schlosser's book is attractive for the same reasons that its subjects are, it is a type of book you do not want to be caught reading. In the United States, especially in the patriotic surge following the 2001 terrorist attacks, it is unfashionable to question nationalistic conventions. If teenagers are drawn to marijuana because their parents forbid it and married men are lured by the pornography stands because it is immoral, is it also possible that disenchanted citizens are tempted by a book that portrays its government and policies as laced with duplicity? We may never know.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Table Of Contents I. Introduction and Overview II. Major Issues In The Book III. Conclusion â€Å"Reefer Madness† overview

Janet Jackson :: essays research papers

Janet Jackson was born in Gary Indiana on May 16, 1966. She is a member of the Jackson Family musical dynasty. Her most famous family members include Jermaine, Stephen, Jackie, Tito, Marlon,and Michael whom were all part of the musical group the Jackson 5. The most famous of the brothers is Michael whom helped Janet begin her musical career. Like many of the women in show business today, Janet has been faced with many obstacles in her life. Despite all of the problems, Janet has overcome most of them and has become one of the biggest successes in the entertainment world today. During Janet’s young years she was forced to deal with difficult conditions at home. She recalls in an interview with Steve Pond in the December 1997 issue of ‘US magazine, "My father whipped me one time when I was a kid. But there was no rape or crap like that. You can begin to see how you feel less-than, not worthy, fraudulent. And that’s how I grew up feeling."(2) Despite problems with other family members Janet was always close with her mother. She said in the same interview with Steve Pond, "Mother always could feel when I wasn’t doing well, and she was incredible supportive." In Janet’s life, as well as in the lives of the other Jackson’s, there seemed to be so much pressure for success, but they all seemed to lack self-esteem. By the time she was twenty-one, Janet was breaking away from the shyness she once possessed, and stopped living in the shadows of Michael and the other Jackson family members. She produced Rhythm Nation in black and white and made this statement, "I would hope that everyone will understand that once black represents something good. That’s why we were all dressed in black†¦Black is so beautiful to me."(3) Janet decided to set a new agenda whenever she produced the Virgin Records album, titled janet. She had a reason for naming her album janet. She describes her reason in an interview by Steve Pond. She said, "I prefer ‘Janet.’ It was always my dream for no one to know that I was a Jackson. I wanted them to accept me for me and to not know anything more than that. I wanted to take my last name off the very first album I ever did."(4) When she named her album "janet" she was taking her steps in breaking away from the Jackson name she had always wanted to avoid.

The Video Game Narrative Essay -- essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The Video Game Narrative   Ã‚  Ã‚  Ã‚  Ã‚  The first argument that arose out of the video game world was the debate of video game violence. Still unresolved, this debate has actually allowed for the video game industry to come fully into the main stream. As the din over violence quieted the fans of the game society began to focus on issues more akin to their own style. So then began the debate of game play vs. the video game narrative. The question arose; can a game also be a story? While the semantics would suggest that, no, a game cannot be a story, we do realize that a game can contain a story. However, considering the amount of games that contain a story we can surmise that this question doesn’t further our study, and realizing that the amount of games (mostly of the 1980’s) that had no story and only gameplay we can see that the story is not a required facet for a game to be successful.   Ã‚  Ã‚  Ã‚  Ã‚  So the question is in need of updating. Is the story contained in today’s games the traditional linear story being contained in a non-linear gameplay arena, or do video game stories possess some special qualities that allow a game to be different from a book or movie. To understand the video game we need to look at one of the video game world’s ultimate predecessors: Dungeons and Dragons. Back in the time when teenage guys dressed up as the character that they had spent month after month making stronger, there existed no video games to fool with. No, this was how the nerds of the day hung out. And much like today, where we have â€Å"Halo bashes† of anywhere from 4 to 16 (16 being the average), the competition between warlock and dungeon master was only the beginning   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Oakley 2 of the excitement. The story that played out in D&D was different every time, depending on how the game was played. And like it’s successor, the RPG’s of today (most notably the Final Fantasy series) play the same way as the games of old. So ... ...  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Oakley 4 a necessity? And what other qualities have taken the main stage of video games today?   Ã‚  Ã‚  Ã‚  Ã‚  The video game world is an ever-changing realm, originally it was a staple way to pass the time, then it became what we looked forward to after a hard day’s work. So as the gaming world becomes more complex, new game types emerge to fill our free time. But very rarely does a game like Pac-Man or Pong come out; a game that has no real story in it, it’s just a way to score points. However it is my belief that even when there is no literal story to a multiplayer game we still have a background to the reason we compete. If one were to take the story of the Master Chief and the Covenant out of the game Halo (2001), we would still have a superb multiplayer game. On the outside it would seem that the only reason to play is to kill the other Spartans, there is no deeper story behind it. However, for the players at least, it becomes a contest, and as you play more and more you remember the other games; you want revenge, you want to be better, or you want to d o something funny.

Chemistry thermo lab, Hess’s Law Essay

Introduction: In this lab, we will be determining the change in enthalpy for the combustion reaction of magnesium (Mg) using Hess’s law. Procedure: 1. React about 100 mL of 1.00 M hydrochloric acid with 0.80 g of MgO. Note the change in temperature and any qualitative data. 2. React about 100 mL of 1.00 M hydrochloric acid with 0.50 g of Mg. Note the change in temperature and any qualitative data. Raw Data: Quantitative: Reaction, trial Mass ( ± 0.01 g) Initial temperature ( ± 0.1à ¢Ã‚ ° C) Final temperature ( ± 0.1à ¢Ã‚ ° C) Volume of HCl ( ± 0.05 mL) Reaction 1, Trial 1 0.80 22.0 26.9 100.00 Reaction 1, Trial 2 0.80 22.2 26.9 100.00 Reaction 2, Trial 1 0.50 21.6 44.4 100.00 Reaction 2, Trial 2 0.50 21.8 43.8 100.00 Qualitative: 1. Hydrochloric acid is colorless and odorless 2. Magnesium tape is shiny after cleaning it from oxidants, increasing its purity. 3. In both reactions, the solution became bubbly. 4. There was a strong odor from the reaction. Data Processing: Trial 1: Reaction 1: First, we have to calculate the ΔT by subtracting the final temperature by initial temperature: 1. 2. 3. Now we calculate the mass of the solution, assuming it has the density as water: 1. 2. 3. 4. Now, we can use q=mc ΔT to calculate the energy gained by the solution: 1. 2. 3. Therefore: 1. Now, we have to calculate the number of moles for MgO: 1. 2. 3. We can now calculate the change in enthalpy by dividing the q of the reaction by the moles of the limiting reagent: 1. Now, we do reaction 2, trial 1 so we can use Hess’s law to calculate the change in enthalpy of formation, but first we are going to calculate the uncertainty in this expression: First, we calculate the uncertainty for the: 1. 2. 3. Now for mass: 1. 2. As for the energy gained: 1. 2. Now for the energy of the reaction: 1. It is multiplied by an integer (-1) so it is the same unc. As for the moles: 1. 2. Finally, the change in enthalpy: 1. 2. 3. Reaction 2: First, we have to calculate the ΔT by subtracting the final temperature by initial temperature: 1. 2. Now we calculate the mass of the solution, assuming it has the density as water: 1. 2. 3. Now, we can use q=mc ΔT to calculate the energy gained by the solution: 1. 2. Therefore: 1. Now, we have to calculate the number of moles for MgO: 1. 2. We can now calculate the change in enthalpy by dividing the q of the reaction by the moles of the limiting reagent: 1. I will now calculate the uncertainties: First, we calculate the uncertainty for the: 1. 2. Now for mass: 1. 2. As for the energy gained: 1. 2. Now for the energy of the reaction: 1. It is multiplied by an integer (-1) so it is the same unc. As for the moles: 1. 2. Finally, the change in enthalpy: 1. 2. 3. Now, we use Hess’s law to calculate the change of enthalpy of formation: 1. MgO(s) + 2HCl(aq) MgCl2(aq) + H2O(l) 2. Mg (s) + 2HCl(aq) MgCl2(aq) + H2 (g) 3. H2(g) + 0.5 O2(g) H2O(l) (given) By reversing reaction number 1, we can get our targeted reaction: Mg (s) + 0.5 O2(g) MgO(s) Now to calculate the change of enthalpy, which will be the change of enthalpy of formation? 1. 2. Our final result is: 1. Mg (s) + 0.5 O2(g) MgO(s) Random error and percent error: We can calculate the random error by just adding the random errors of the component reactions: 1. 2. 3. As for the percent error: 1. 2. 3. Trial 2: Reaction 1: First, we have to calculate the ΔT by subtracting the final temperature by initial temperature: 1. 2. Now we calculate the mass of the solution, assuming it has the density as water: 1. 2. 3. Now, we can use q=mc ΔT to calculate the energy gained by the solution: 1. 2. 3. Therefore: 1. Now, we have to calculate the number of moles for MgO: 1. 2. 3. We can now calculate the change in enthalpy by dividing the q of the reaction by the moles of the limiting reagent: 1. Now, we do reaction 2, trial 1 so we can use Hess’s law to calculate the change in enthalpy of formation, but first we are going to calculate the uncertainty in this expression: First, we calculate the uncertainty for the: 1. 2. 3. Now for mass: 1. 2. As for the energy gained: 1. 2. Now for the energy of the reaction: 1. It is multiplied by an integer (-1) so it is the same unc. As for the moles: 1. 2. Finally, the change in enthalpy: 1. 2. 3. Reaction 2: First, we have to calculate the ΔT by subtracting the final temperature by initial temperature: 1. 2. Now we calculate the mass of the solution, assuming it has the density as water: 1. 2. 3. Now, we can use q=mc ΔT to calculate the energy gained by the solution: 1. 2. Therefore: 1. Now, we have to calculate the number of moles for MgO: 1. 2. We can now calculate the change in enthalpy by dividing the q of the reaction by the moles of the limiting reagent: 1. I will now calculate the uncertainties: First, we calculate the uncertainty for the: 1. 2. Now for mass: 1. 2. As for the energy gained: 1. 2. Now for the energy of the reaction: 1. It is multiplied by an integer (-1) so it is the same unc. As for the moles: 1. 2. Finally, the change in enthalpy: 1. 2. 3. Now to calculate the change of enthalpy, which will be the change of enthalpy of formation: 1. 2. Our final result is: 1. Mg (s) + 0.5 O2(g) MgO(s) Random error and percent error: We can calculate the random error by just adding the random errors of the component reactions: 1. 2. 3. As for the percent error: 1. 2. 3. Processed data: Trial 1 Trial 2 of reaction 1 -104 kJ/mol ( ± 2.10%) -99 kJ/mol ( ± 2.19%) of reaction 2 -463 kJ/mol ( ± 0.509%) -446 kJ/mol ( ± 0.525%) of MgO -645 kJ/mol ( ± 2.61%) -633 kJ/mol ( ± 2.72%) Conclusion and Evaluation: In this lab, we determined the standard enthalpy change of formation of MgO using Hess’s law. First, we reacted HCl with MgO for the first reaction and got -104 kJ/mol ( ± 2.10%) for trial 1 and -99 kJ/mol ( ± 2.19%) for trial 2. As for reaction 2, where you react, I got -463 kJ/mol ( ± 0.509%) for trial 1 and -446 kJ/mol ( ± 0.525%) for trial 2. When we use Hess’s Law, we have to reverse reaction 1 to get the targeted equation, Mg (s) + 0.5 O2(g) MgO(s), and we get an enthalpy change value of -645 kJ/mol ( ± 2.61%) for trial 1, and -633 kJ/mol ( ± 2.72%) for trial 2. For trial 1, my value got a percent error of 7.14%, which is not that bad considering the weaknesses this lab had that will be discussed in the evaluation. However, in trial 2, I got a better percent error, which is 5.15%, we got a better value because we had a bigger ΔH values thus when adding them (since one of them is positive and the other two is negative) we get a smaller value for the enthalpy change of formation thus bringing us closer to the theoretical value. The biggest weakness in this lab was the impurity of the substances, the assumptions that we made about the HCl solution, for example, we assumed that the specific heat capacity of the solution is the same as water, which is an assumption that is not a 100% accurate and affected our ΔH values for both reactions and eventually our final ΔHf value. To fix this, In the different range of specific heat capacity values, 4.10 j/g k would have been more appropriate to get closer to our theoretical values, as you get a bigger qrxn values thus bigger ΔH values. Another thing that I noticed is that the theoretical value that I got was the â€Å"Standard† enthalpy change of formation. Standard meaning at standard conditions which are at 293 K and 101.3 kPa for pressure. These weren’t the conditions in the lab when I did the experiment. This might alter the experimental value closer to the theoretical value reducing the percent error.

Pathophysiology of COPD Essay

This naming forget explicate the pathophysiology of the infirmity surgery inveterate jam pulmonic distemper ( COPD ) . It will analyze how this dis sculptural relief affects an unity viewing at the biological. mental and societal facets. It will carry by dint of this by mentioning to a long-suffering who was admitted to a checkup ward with an aggravation of COPD. Furtherto a greater extent with angleing of Gibbs theoretical name of contemplation ( as cited in Bulman & A Schutz. 2004 ) it will study how an dwell altered an strength. In configuration with the Nur hum and Midwifery Council. ( NMC ) formula of skipper Conduct ( NMC. 2005 ) warble safeguarding patient knowledge no names or topographical steers will be divulged. Therefore by dint ofout the assignment the patient will be referred to as toilet. arse is a 57 twelvemonth former(a)(a) gentleman who has been unite to Mavis for two old ages. fanny was admitted to the ward with terrible shortnes s of joting room expectorate and inordinate phlegm production. By looking with bunss notes it was discovered this was an aggravation of COPD.To comprehend tushs status it is utile to look at how the habitual respiratory body licks. The routine of the respiratory System is to add the organic mental synthesis with O and fool C dioxide ( Marieb. 2004 ) . Harmonizing to Waugh and own up ( 2004 ) it besides helps rem somebodyal organic mental synthesis temperature and extinguish particular(a) H2O from the organic structure. The respiratory arranging consists of the oral cavity. rhinal pit. throat. voice box. windpipe. bronchial tube and the lungs ( Seeley. Stephens & A Tate. 2000 ) . line enters with either the oral cavity or ol chemical elementy organ which humidifies and cleans the circularise. ( Cohen & A Wood. 2000 ) unite into a common chamber called the oropharynx ( Watson. 2000 ) . Air so leaves to the throat. a short. funnel-shaped tubing that transports strown(prenominal) to the voice box ( Waugh & A Grant. 2004 ) . The atmosphere enters the voice box which is lie with mucous membrane and returns to the windpipe. which is formed of semi-circular gristle rings. The midland membrane of the windpipe contains h line of reasoning cells and mucose cells which trap atoms and brush them toward the bronchial tube. The bronchial tube atomic number 18 besides seamed with mucose membrane and ringed with gristle ( Marieb. 2004 ) .Each bronchial tube is lined with mucose membrane. ( Martini. 2000 ) and extends into a lung where it subdivides organizing smaller bronchioles ( Watson. 2000 ) . Bronchioles apprize with the mien sac which ar the utilitarian units for gas exchange and ar thin. dampish and surrounded by capillaries ( Clancy & A McVicar 2001 ) . Inhaled advertise travels through these air passages to the air sac. root is pumped out of the bosom through the pulmonic arterias to the capillaries environing the air sac. ( S haw. 2005 ) The O of the inhaled air diffuses out of the air sac into the smear. plot C dioxide in the blood moves into the air sac to be exhaled ( Tortora & A Grabowskie. 2003 ) . The oxygen-rich blood is returned to the bosom through the pulmonic venas.The lungs thr iodine spread out and contract without collide during cope a schnorcheling ascribable to the pleura. a thin membranous tress ( Tamir. 2002 ) . The splanchnic pleura surround the lungs. while the parietal pleura line the wall of the pectoral pit. These pleura be separated by a low unstable-filled infinite called the pleural pit. Ventilation requires work and before the lungs potbelly go hyperbolic. a force per unit area registration must deem topographic point. The flexible belongingss of the lung let airing to organise topographic point more than than than expeditiously and the fluid in the pleural pit serves as a lubricator that allows the lungs to skid against the authority wall ( Marieb. 2004 ) . whoremonger notified the lag that he was diagnosed with COPD twelve months ago by his command practician ( G. P. ) . He added that he repeatedly went to his G. P. as he had been experiencing breath slight(prenominal). which was going corrected and was present every twenty-four hours. more so when he exercised. This shortness of breath he revealed was accompanied by a cough alongside phlegm production. put-ons G. P inquired if he have and how many. pot informed him he has take over around 30 coffin nails a twenty-four hours for 42 old ages. The doctor so gave bottom a lung map trial utilizing a spirometer. nates was notified by his General practitioner that he had COPD which. behind was informed. was both inveterate bronchitis and emphysema ( field Lung health schooling Program. 2005 ) .The World Health Organization ( WHO ) ( 2006A ) defines COPD as a complaint res publica characterized by airflow limitation that is non entirely reversible. The airflow restricti on is ordinarily both progressive and associated with unnatural seditious response of the lungs to noxious atoms or gases. Johns chronic bronchitis is defined. clinically. as the comportment of a chronic productive cough for 3 months in each of 2 consecutive old ages. provided new(prenominal) causes of chronic cough have been ruled out. ( Mannino. 2003 ) . The British lung psychiatric hospital ( BLF ) ( 2005 ) announces that chronic bronchitis is the redness and ultimate scarring of the liner of the bronchial tubing which is the account for Johns dyspnoea. The BLF ( 2005 ) remember that when the bronchial tube drop dead inflamed less air is able to flux to and from the lungs and one time the bronchial tubings have been stung over a long point of powder store. inordinate mucous secretion is produced. This change magnitude sputum consequences from an addition in the surface and figure of goblet cells ( Jeffery. 2001 ) ensuing in Johns inordinate mucous secretion productio n. The liner of the bronchial tubings becomes thicken and an annoying cough develops. ( Waugh & A Grant 2004 ) which is an extra symptoms that toilet is sing.Emphysema affects the parenchyma of the lung through devastation of the alveolar walls. taking to long-wearing expansion of air infinites distal to the remainder bronchioles ( Sandford. Weir & A Pare. 1997 ) . The walls between next air sac interrupt surmount. the alveoli corporationals dilate and thither is loss of interstitial elastic waver ( Watson. 2000 ) This consequences in dilatation of the lungs and loss of normal elastic kick. therefore pin toss off and stagnancy of alveolar air ( matter Emphysema Foundation. 2006 ) . As alveoli merge there is loss of surface country for gasified exchange ( Alexander. Fawcett & A Runciman. 2004 ) ensuing in less O. This loss of country for aerosolized exchange is an extra account for Johns dyspnoea.John was referred to the physical healer to assist relieve his shortness o f breath and mucous secretion production. turner nourish & A Johnson ( 2005 ) pronounce physical therapists are cardinal members of the treatment squad. empennage information and give John practical instruction on how he buttocks take a breath comfortably and efficaciously. ( get together soil Parliament. 2005 ) . Van der Schans. Postma. Koeter & A Rubin ( 1999 ) counsel physical therapists facilitate Johns mucous secretion conveyance by utilizing take a breathing techniques. pleximetry and postural drainage. Furthermore they female genitalia acquire John on organic structure identifyment as this is cardinal with population with COPD ( Gosselink. 2003 ) .to boot John was referred to the occupational healer ( OT ) who assessed his current point of fittingness and so formulated a plan of activities which will better his overall strength and staying power. The OT can besides give advice to John to consecrate off his status with the least trouble and break of day-to -day keep ( Turner Foster & A Johnson 2005 ) . Furthermore the case make up of Health and Clinical righteousness ( NICE ) ( 2004 ) urge patient with COPD should be on a regular ass asked nearly their ability to set round activities of day-to-day life and how breathless they become when making these.John was informed that his COPD was perhaps caused by skunk. Kanner ( 1996 ) believes that the major environmental factor of COPD is tobacco fume. The world(a) Initiative for inveterate Obstructive Lung disorder ( GOLD ) ( 2005 ) concurs and provinces nance green goddess is by far the close to of second hazard factor for COPD. This harmonizing to the interior(a) aggregate Blood and Lung Institute ( NHLBI ) ( 2006 ) is because have irritates the lungs. which causes the air passages to go inflamed and narrowed. Additionally Verra. Escudier. Lebargy. Bernaudin. De Cremoux & A Bignon ( 1995 ) adds that enzymes released because of the redness breaks down elastin. the protein of import for structural unity of the lungs. making take a breathing air in and out of the lungs more hard ( NHLBI. 2006 ) even Dhulst. Maes. Bracke. Demedts. Tournoy. Joos & A Brusselle ( 2005 ) states non all tobacco users develop clinically important COPD. which suggests that familial factors must modify each respective(prenominal)s hazard ( WHO. 2006B ) . John rests to plenty although he has reduced his consumption that NICE ( 2004 ) guidelines suggest all COPD patents who continue to smoke should be encouraged to halt. and offered sanction to comprise so. at every find out because. locoweed cessation is the psyche intimately foundual manner to cut down the hazard of developing COPD and halt its model advance ( WHO. 2006B ) . John was encouraged to halt. disposed over counsel on how to halt. was informed nigh a smoke surcease sort that he could go to and in affix offered nicotine spots nevertheless he refused and told staff that he would discontinue in his a in tog.John explained to the nurse that for the past a couple of(prenominal) months he has been experiencing low. can non concentrate and has a deficiency of involvement in anything. he says he does non understand why he is experiencing this manner. Gross ( 2001 ) believes these symptoms could be a augury of drop-off. Harmonizing to Kunik. Roundy. Veazey. Souchek. Richardson. Wray & A Stanley ( 2005 ) many CODP patients develop psychological symptoms in add-on to physical ailments. Harmonizing to Kunik & A Densmore ( 2002 ) this is because of the nature of the infirmity and the fright of world breathless. The BLF ( 2005 ) concur and believe take a breathing trouble can start anxiousness and depression. Other causes stated by Ohri & A Steiner ( 2004 ) include body image. change magnitude solitariness. deficiency of societal support. and low self-pride. Kunik et Al ( 2005 ) study that depression and anxiousness are two to three times more prevailing in COPD patients than i n the superior general population and the account for this is because of the sustained and stark feelings of defeat. hopelessness and weakness.Johns downhearted temper could take down his degree of energy needed to get by with his chronic unwellness. which. in bend. could do his symptoms less tolerable. ( Singer. Ruchinskas. Riley. Broshek & A Barth. 2001 ) Depression besides can take to increased badness of Johns medical symptoms since feelings of depression can do a individual to be less active. and. in bend. whitethorn worsen physical impairment. which can escalate the psychosocially incapacitating effects of COPD ( Van Ede. Yzermans & A Brouwer. 1999 ) . up to now a survey by Engstrom. Persson. Larsson. Ryden & A Sullivan ( 1996 ) found that quality of life is non significantly affected in patients with mild to control COPD. perchance due to get bying and/or pulmonic modesty capacity.John was given the chance to speak to a headhunter since mental wellness specializ er can name depression and put up capture intervention. One intervention that was suggested was pneumonic replenishment. Mahler ( 1998 ) states these plans integrate psychosocial and behavioural constituents. Emery. Leatherman. Burker & A MacIntyre ( 1991 ) agree and suggests that it can besides heighten cognitive functioning and psychological wellbeing. Surveies by Withers. Rudkin & A unobjectionable ( 1999 ) repeat this and demo that degrees of anxiousness and depression were significantly enhanced by pneumonic renewal.John was 56 when he was diagnosed with COPD. He stated he was forced to take early retirement from his employment where he assisted in the fix. installing and like of H2O and sewer lines. This. he believes was because of the square up lost at work caused by his dyspnoea. Mavis declared she besides had to annul from her portion clip occupation as a cleansing agent to take aid of John since she is his lone carer and is exhausted. Their income is from gove rnment activity benefits and a little pension and they say they are happening it hard to plume off on the sum of cash they receive. Strassels. Smith. Sullivan. & A Mahajan ( 1987 ) reported that the typical COPD patient was more than 65 old ages old and had limited work loss bully related to his or her affection. However a survey by Tinkelman & A Corsello ( 2003 ) indicated that COPD is non merely a disease of the aged. They province a big per centum of patients with COPD are unable to work. and those who do work lose yearss as a consequence of their disease. This state of affairs they believe is of great concern to the single histrion who may lose his occupation as a effect of inordinate absenteeism. degenerative unwellness and disablement are strongly category related ( Taylor & A sketch 1993 ) and those in the lower socio-economic groups are the closely affected. Smoking. the greatest hazard factor for COPD and characterisation to occupational factors from manual uns killed occupations. such(prenominal) as excavation and foundry working(a) are high-pitchedest amongst males in the lower socio-economic groups ( Parnell. 2000 ) . COPD patients and their households tend to be members of this group and are much aged as symptoms become inquiring in the fifth and 6th decennaries of life which is Johns state of affairs. Webb & A Tossell ( 1999 ) maintain that pensions frequently reflect an individuals category and societal military strength and as a consequence more adult females. retired manual proles and cultural minorities are disproportionately represented in old age as being on the borders of poorness.A trust on province benefits may be a effect if forced to retire early and carers may non be entitled to benefits in their ain right. The fiscal load is increased by the costs of disablement such as interpose changes and aid in the place or conveyance ( Young. 1995 ) . To assist John and Mavis a societal worker was involved who assisted with p lace attention aid when John was discharged so Mavis could hold some clip for herself. Additionally the OT was involved and provided equipment to assist John keep his independency ( Trombly & A Radomski 2000 ) .Although I was witting. through survey. other wellness professionals and through nurse conceptualization. that smoke can be damaging to wellness and can do diseases such as malignant neoplastic disease ( Newcomb & A Carbone 1992 ) atherosclerotic diseases ( McBride. 1992 ) and COPD ( British Thoracic conjunction. 1997 ) I was unwilling to give wellness publicity and smoke surcease advice since I smoke myself. Several surveies exhibit that I am non entirely in this thought. Surveies by Dore & A Hoey ( 1998 ) and Adriaanse. Van Reek. Zandbelt & A Evers ( 1991 ) show that high smoke rank among some populations of nurses may decrease their willingness and effectivity as possible suppliers of smoking surcease attention. An extra survey by Nardini. Bertoletti. Rastelli. Ra velli & A Donner ( 1998 ) demonstrated that smoking wonts influence the pose of wellness staff toward patient reding nearly baccy smoke. I considered that it was non my topographic point and felt hypocritical if I essay to give advice on halting smoke. On meeting John my feelings did non alter despite the fact that I could see the effects that COPD had on Johns foreign respiration.However on disbursement clip with John and Mavis my attitude altered. I realized that if John stopped smoking so his status. although his lost lung map would non be regained. ( Booker. 2005 ) will be slowed down ( Osman & A Hyland. 2005 ) . I became cognizant of the fact that I was in a premier place to economic aid John in holding his independency. to educate and to assist better Johns quality of life through wellness promoting and advice on smoking surcease. Although John decided non to give up this did non caution me on giving wellness publicity advice on smoke. On speaking to other patients I took the chance to speak about halting smoking although I did non make this sharply ( Seedhouse. 2004 ) . This experience with John changed my feelings sing wellness publicity and smoke. Although I chill out feel slightly hypocritical. I allow the importance of my place and how it can ease patients and their lives. I believe I understand the troubles patients face when trying to discontinue. possibly more than a womb-to-tomb non tobacco user. I will go on to supply smoking surcease advice throughout my preparation and besides throughout my calling.In decision this assignment has explained the pathophysiology of COPD through presenting a patient. It examined how this person has been affected holistically. Finally it demonstrated how an experience encountered altered an sentiment with aid from a brooding theoretical account.MentionsAlexander. M. F. . Fawcett. J. M. . & A Runciman. P. J. ( Eds. ) . 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