Personal Goal Essay Example for Free

Personal Goal Essay My purpose for seeking a Doctorate Degree in Educational Leadership is to expand my knowledge of theory and research methods as it pertains to education Being a seasoned professional in the field of education as a Master Teacher for fifteen years, and having been exposed to different challenges in teaching the learners and leading the school, I had this profound realization on the critical tasks of education in this age of globalization. The way schools are led and managed is changing. The types of school leaders and governing bodies that exist today are far more diverse than they once were; and they will continue to develop given the fast-paced movement of modern technology which affects how people and society evolve nowadays. Hence, this complexity calls for leaders with exemplary leadership style that are worth emulating for others so as to make a real distinction in the lives of many people, not only in a community, but for the country, as a whole. Educational leadership and management as a field of inquiry play a significant role in the improvement of schools; leveraging learning outcomes; and enhancing instructional competence of students. In schools, high performance rating and high literacy rates among their clienteles connotes success in one’s governance in education, thus, in making relevance to the system, educational leaders need to exercise certain leadership models that are truly manifesting merit in order to achieve its goals. And I think I already have what it takes to become a leader who can have the knowledge and skills to make these goals a reality.

Physics of the Bottle Flip Challenge

Physics of the Bottle Flip Challenge One of the biggest trends of 2016 was the water bottle flip challenge, and almost everyone was trying their hand at it. But, there is much more to it than just skill and luck, and-even though the trend seriously died out-Ill be teaching you a few cheats that are going make you flip! Or at the very least give you the ability to become the mic-dropping finale at your schools talent show. But in all seriousness, of all the trends to hit big in 2016, bottle flipping was perhaps the most surprising. Sure, we expect the collective mind of the internet to dredge up long forgotten childhood shows, ironically appreciate terrible movies, or recreate popular dance moves; but flipping bottles of water so that they can land correctly? Its something almost anyone can do, watch, and appreciate. You see it happen and you understand it regardless of how old you are or what language you speak. But, for those of you who many not be familiar, here is a quick summary. Bottle flipping entails taking a bot tle and tossing it so that it twirls through the air like a gymnast, and sticks a 10/10 landing. Now, despite what Know Your Meme-a website that dedicates itself to documenting online phenomena and memes-might say, the origins go back as far as 2007 to a video released by a skateboarder named Ben Daleman. However, it was Michael Senatores epic flip during his school talent show last year that really caused people to flip out over the flip. As elegantly simple as bottle flipping might be, scientifically, its a completely different story. Involving everything from elasticity of collisions, to fluid dynamics, to momentum, to laws of gravity, the science behind the bottle flip is quite amazing. But, once you understand that science, youll actually have an unfair advantage in your next bottle flipping tournament, at your next school talent show, your next visit to grandmas house, or whenever you might just want to impress someone. Now, without further ado: The Scientific Cheat Code Thatll Get You the Upper Hand in the World of Bottle Ballistics. Before you start pitching your old plastic around, your flip can either be made or lost by the very first choice that you make-the bottle. There are hundreds, if not thousands of different brands of bottled water on the market. As well, almost all of them have different bottle shapes, heights, even thicknesses of plastic, and picking the right one can make the difference between becoming a flipping champ, or a flipping chump. So if you think of bottle flipping as a video game, then think of your choice of bottle as the difficulty level. The typical bottle most people are using rounded bottle, thin plastic, like Poland Springs, those are effectively the normal setting. Not too hard, not to easy, just a good sweet spot to judge other bottles. But what in particular makes this one the ideal, middle candidate? Well, lets take two other bottles and itll all become clear. A water cooler jug, and a bottle of Coca-Cola. Now, the Coca-Cola bottle is the bottle flipping equivalent of hard mode, and the reason for that is surface area. Notice that the bottom isnt round like the other two, but rather has multiple prongs that give the bottle added stability. Now, under normal usage, thats a great shape, but when flipping bottles, it is a completely different story. Â   Â   You see, in physics, the energy of being in motion is called kinetic energy, and the word elasticity is a measure of how much kinetic energy remains as kinetic energy after two objects combine. To give you an example, lets look at anime. Goku punches Krillin in the face. Gokus fist has a bunch of kinetic, or movement energy. That then is transferred into Krillins face and body launching him off for miles. So, one would say that the elasticity of that collision of fist to face is really high. The kinetic energy of Gokus fist stays as movement energy as Krillin flies through the air. So thats an elastic collision. Alternatively, there are inelastic collisions, where the kinetic energy is transformed into deforming the material, or where energy is lost in other ways, like heat and sound. The Goku punch example isnt perfectly elastic, because some of his punch energy is lost deforming Krillins face. A good example of an inelastic collision is two balls of clay thrown together. They stick , there is no bounce, all the kinetic energy of the two balls moving is lost as they deform into one larger ball. Now, knowing all that, look at our bottle flip. Its plastic hitting a table, so the collision would be mostly elastic, where the kinetic energy of the bottle falling is preserved. But, the table isnt going to move so that movement energy has to go somewhere, and thats back into the bottle-which is causing it to bounce. The plastic of the bottle compresses ever so slightly, and then springs back into position, causing it to rebound from the table and potentially costing you your glorious moment at the talent show. Yet, as that may be, the force isnt going to cause a ton of bounce when its spread out over a wide surface such as the rounded bottom of your average water bottle. But what about the prongs of the Coca-Cola bottle? That force is moved to the very small area thats actually hitting the table, causing the bottle to rebound higher and thus making it harder to get th at perfect landing. Whereas on the other end of the spectrum are the large jugs of water-which are the equivalent of flipping easy mode. Part of it is the huge surface area of the base, but to see why these are the clear choice for any inexperienced flippers we need to talk about the other elephant in the room-finding the perfect water level. Empty water bottles weigh practically nothing, averaging in at 10 grams, and if you have an empty water bottle just sitting on a table, its center of mass-the point on the bottle where all the mass averages out-is right around the middle. But water is a lot heavier than plastic, and when you put something like water into a bottle, the center of mass is going to move. In this case it moves downward. Theres more mass on the bottom of the bottle than on the top, and thus the place where the mass averages out is going to end up a lower. Now, why is that important? Because the center of mass sometimes goes by another name, the center of gravity, and gravity-as the largest obstacle between you and that perfect bottle flip-pulls from the center of gravity. Therefore, the lower the center of gravity is, the less likely that bottle is going to tip over when you flip it. Thus, allowing you to walk off the high school stage head held high. But if you overfill the bottle with water now the cente r of gravity is much higher, the point at which all the mass has averaged out has crept back upwards. When that happens and its tipped to the left, the center of mass is now to the left of the tipping point, and gravity will pull the bottle down, causing it to fall, and causing you to take the walk of shame, or move to another school district. This is why getting just the right amount of water is tricky and essential. You need to put in enough water in the bottle so that the center of mass goes about as far down as it can get without inadvertently allowing that center of gravity to creep back upwards by overfilling. So mathematically the ideal sweet spot is going to be filling up that bottle to the one-third mark. Its there that the center of mass is going to be about as low as it can go. Those wide, short squat, water cooler bottles are the easiest ones to flip because theyre the ones where keeping the center of gravity low is a cinch. It doesnt take a lot of water to weigh them do wn-getting their center of mass low-and all in all these jugs are just super stable. Now obviously youre not going to shove a water cooler jug in your backpack to pull out during lunch hour bottle flipping tournaments. So what bottle do you choose? Well, in between these jugs and our standard round-bottomed ones is everything from Smart Water-being tall and narrow-to Fiji water-being made from a firmer plastic and with a wider base, and shorter height. The fact that Fiji water is short means that youre going to have to be a lot more precise in your water level measurements making it much harder to land the flip; therefore, making Smart Water a little more incentivizing. Lastly, and arguably the most important part of each flip: the throw. Now, before we talk about throwing bottles, lets talk hammers. Grab a hammer and toss it in the air! Eh, actually, no. Its dangerous and youll put a hole in the floor. Instead, lets visit historys most famous hammer tossers-The Hammer Bros. Notice how the hammer twirls all lopsided? Well, its because of our old friend-the center of mass. Objects in free fall that have any rotation will always rotate around their center of mass. Hammers, which traditionally have wooden handles and steel heads, have a hugely lopsided center of mass and rotate around that. But the cool part is, for as chaotic as that movement looks, if you trace the trajectory of the center of mass it will always follow a perfect arc. But heres the thing, for as complicated as throwing a hammer may look, a water bottle is even more complicated because of fluid dynamics. When you flip the bottle into the air, the center of mass is shifting as the mass of the water moves around in the bottle. As it does this, the water robs the bottle of angular momentum-or spin. This becomes most dramatic just after the bottle flips, when the water sloshes around and goes from being in the bottom of the bottle to the top. It adjusts to gravity, which simultaneously helps push the bottle down, allowing for that signature straight-up landing. How this knowledge helps you is that most newbie bottle flippers include too much horizontal velocity. You see, if the bottle is moving forward too fast when it lands, the bottles movement is suddenly stopped, but the water inside the bottle still wants to move forward. And it does, which takes all the mass with it. So instead of acting like a stabilizing force inside the bottle, the water actually helps knock the bottle over. The key here is to try to use as much force upward while also putting that spin on the bottle. The best way to do this is to make sure the bottle is parallel with the ground when you rel ease it. This sends the center of mass straight upward, and since youre holding onto the other end, the bottle with naturally rotates as you let go. So, there you have it, the steps to a prefect flip. Choose a bottle with a firmer plastic and a wide base like a Fiji bottle, fill that bottle to about a third full, double-checking the exact level by doing that 45 degree fall test to measure where the center of gravity is at, and then practice your toss so that you release it in parallel with the ground, and try to minimize its forward momentum. But if you want even more of an edge, consider swapping out the water in the bottle for Mercury. As the heaviest liquid at room temperature, that should lower the center of mass to amazing depths while still maintaining all the benefits of fluid dynamics. Just, fair warnings, dont drink it, or touch it, or do anything with it really because its toxic. Between Mercury and hammer tossing, explaining the science behind bottle flipping can be filled with bad ideas.

Principles of Acid Base Balance

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

Womens Progress in the Late Nineteenth Century :: European Europe History

Women's Progress in the Late Nineteenth Century Women didn't gain the right to vote until the twentieth century but great strides were made starting in the 1840s to help women on their way to winning legal privileges and responsibilities.   Below is rundown by year of the most important laws passed in England to try to help out the situation of all women, especially working and middle class.   Just imagine what life would have been like before these laws were passed.   We read all the time about women who complain about being helpless.   How often is that claim believed?   Women were practically helpless and almost completely dependent upon either family or husband in the eyes of the law.   Unless a girl became a wealthy widow or stayed a pitied spinster she had no chance of being independent.   But as you will soon see, the road to change is a rough and repetitive one.    1839- The Infant Custody Act is passed.   It states that any woman who can enter a suit and prove herself inoccent of adultery may have custody of children under seven years of age and periodic visitation with those under the age of consent (sixteen).   Of course most women weren't independently wealthy so they couldn't enter a suit and the act also kept justly, or unjustly, charged adulteresses away from their children with no similar provision towards unfaithful husbands. 1857- The Married Women's Property Bill (two versions)   One version of this bill declared that marriage laws needed a serious overhaul, that married women should have the same property rights as single women, and that women should have speedy access to the courts to gain protection for their property.   But this version dropped out of sight.   The other version didn't change the court system at all but did propose letting women control their own property after marriage, allowing them to dispose of it according to their will, and to apply the same inheritance rules to a deceased woman's belongings as to a man's.   This bill was approved on its second reading but dropped due to the passing of the Divorce Act the same year. 1857- The Matrimonial Causes Act- The Divorce Act, as it was called, gave courts the decision on who to award custody to.   This meant that women who had been found guilty of adultery could gain custody of their children if the courts   Ã‚  Ã‚   thought that was what would be best.

Leaders of the Nation of Islam Essay -- Black Muslim Malcolm X Elijah

Leaders of Nations The Nation of Islam impacted many African American people during its time. This Black Muslim nation demanded adherence to basic teachings, which included racial separation, white devilry, and the coming Armageddon. None of these basic teachings supported James Baldwin’s perceptions, which pitied whites for their inability to see through the color curtain and embrace differences that whites and blacks held together to create a better, inexorable, and supreme nation. Leaders such as Elijah Muhammad and Malcolm X provided the vision of the Nation of Islam. These moguls proved to be two of the most powerful leaders of their time. They paved their way through history and rightfully landed a spot belonging to the Islam nation. Even after death, Elijah Muhammad and Malcolm X still influence people in communities around the world to look beyond themselves and conquer a solution to the problems that societies still face. However there were some that did not concur with the Nation of Islam, and one of these people was James Baldwin. Although Baldwin, like a lost child, is not confident as to where or to whom he belongs to in life, Baldwin is certain that a black nation separated from all other races will only separate blacks from the future of a better nation and keep them from further developing as a community. Born in Georgia on October 7, 1897, the first leader of the Nation of Islam was a man named Elijah Muhammad. He has often been portrayed as a saint by his peers, but during World War II, Elijah Muhammad expressed support for Japan, on the basis of its being a nonwhite country, and was jailed for sedition. On August 24, 1946 Muhammad was released from prison in Milan, Michigan. Accord... ...We Need Not Look for Another. Phoenix, Arizona: Truth Publications, 1971. Harris, Robert L. "Malcolm and the Cross." Rev. of Malcolm and the Cross: The Nation of Islam, Malcolm X, and Christianity, by Louis A DeCaro Jr. New York University Press 1998. Hoffer, Eric. "The Negro Is Prejudiced Against Himself; The Negro Is Against Himself." New York Times 29 Nov. 1964, sec. M: 27-35. Kihss, Peter. â€Å"In Return for Years of Slavery, Four or Five States.† New York Times 23 Apr 1961: 1. Kihss, Peter. â€Å"Negro Extremist Groups Step Up Nationalist Drive.† New York Times 1 March 1961: 2. "Man of Myth and Fact: Elijah Muhammad." New York Times 29 June 1964: 32. Trinklein, Rhaya. The Official Website of Malcolm X. 24 Nov. 2003. CMG Worldwide. .

Review of “Peer-E-Kamil” Essay

Pir-e-Kamil (SAW) meaning The Perfect Mentor, is one of the fiction novel written by well known and famous Pakistani writer Umera Ahmed. The book was firstly published in 2005 in Urdu language and later on in 2011 the book was published in English language too. I have decided to write review on this book because I found the book an extraordinary attempt by the writer Umera Ahmed. I have selected this book for review because the facts shown in the book were heart & soul shaking. Many among us don’t think about these facts and coming life but only consider it as to have the luxuries and to relax after working hard for gathering as much luxuries as they can. The only right path starts from ALLAH and ends at his beloved last Prophet Hazrat Muhammad (SAW) but unfortunately not as many of us thinks about it. Umera Ahmed was born on December 10, 1976 in Sialkot. Umera Ahmed completed her masters in English literature from Murray College,Sialkot. She began her writing career in 1998 with her initial stories published in monthly Urdu digests. She has written 16 books, ranging from complete novels to compilations of short stories. Her most popular book is the current book of which I am presenting the review Pir-e-Kamil (SAW). This book became identity for Umera Ahmed. Later she became an English language lecturer for the students of O and A levels at Army Public College, Sialkot. However, she left the job a few years back in order to devote her full attention to writing. Her novels and her plays have been adapted for television. Umera Ahmed is one of the most widely-read and popular Urdu fiction novelist and screenplay writer of this era. Her stories revolves around many social, domestic and spiritual issues and consists of colours of true love, friendship, suspense and tragedy. What differe ntiates her from others is her ambition of bringing light on certain controversial issues of modern era. Pir-e-Kamil, is our Prophet (S.A.W) someone the whole Muslim Ummah loves. The story of ‘Pir-e-Kamil’ is about a girl named ‘Imamah’ who went through many changes in her life because of her love for Allah and His Messenger S.A.W. Pir-e-Kamil is a story of Imamah Hashim, who belongs to a family of Qadiyanis. Qadiyanis are a group of people who choose divergence from true Islam by selling their faith and these are considered non-believers by Islamic Law and according to the Law of Pakistan too. Imamah grews up in that family but feels something to be missing in her life. She found what she was looking for in Islam. Her conversion to Islam brought some serious and difficult challenges to her life, and faced rejection and harsh behavior of her family on becoming a Muslim. Her family planned her wedding with her cousin â€Å"Asjad† who was also a Qadiyani. As It isn’t permissible for a Muslim woman to marry a non-Muslim, so she asks for her Muslim neighbors, Salar’s help. Salar was one of those special people who have 150+ IQ level and amazing memory. This book is also about the story of Salar Sikander, a very different and complicated character, who was living a sinful and worse life like the life of anyone in the world but not that of how a good Muslim should live. He had tried to commit suicide a few times just because he wants to feel the pain. After that story the book is about the hardships these characters face in life. The book tells us that Any success in this world and in the next World, is only granted for the love of Holy Prophet (SAW) and beyond that there is nothing that a person requires. Nothing. The writers expressive style does justice to the wonderful plot and by the end of the novel you cant help but at least think over the lessons and morals in the book. The novel’s plot, facts expressed in the novel, the scenes hence, everything was heart touching, heart shaking and perfect. It is not just an ordinary novel, but Pir-e-Kamil will let you examine your own life and see if the lives we are living are in accordance with what Allah (God) wants us to live like in this World. The story of the book is such a great one that no one can sit without admiring it. It shows the people who love Allah and His Messenger (SAW) and how people have changed by the will of Allah through other people. It is spiritual story. I’m sure that there are many people who go through such phases in their lives, infact I think everyone gets a chance at least once in their lives. It also depends on who want that change. Surely, Allah listens and knows what’s in our hearts. One of my favorite parts was when Salar was in a â€Å"fishy† area and hears the name Imamah and the way Umera described his reaction was just superb and fabulous. Great characterization shown by Umera Ahmed in this book. Your heart totally went out for Salar even when you knew he wasn’t a good guy – what a great way to craft a character in the book. It is really a masterpiece of Umera Ahmed and no doubt the book has a magic spell .Although it is totally a fiction novel but after reading this you will just think that may be Salar Sikandar exists or Imamah exists in this World. The concepts , the characters , the dialogues every single thing in book was amazing. Personally the character of Salar Sikandar left me totally mesmerized. I loved the transition of his characters the way he changed is quite interesting. Overall this book is a Masterpiece from the Author. I will surely recommend this book to all people. It is such a type of book which have everything In it and once reading it no once can be restricted from appraising the work of author. A surely recommended book to everyone. I highly recommend this book to everyone because it has got to be one of the most amazing novels ever. It is definitely worth reading. â€Å"â€â€"In life, at sometime or another we come to a point where all relationships cease—where there is only us and Allah. There are no parents, brother or sister, or any friend. Then we realise that there is no earth under us nor is there sky above, but only Allah who is supporting us in this emptiness. Then we realise our worth – it is not more than a grain of sand or the leaf of a plant. Then we realise our existence is only confined to our being. Our demise makes not a whit of difference to the world around us, nor to the scheme of things.† ― Umera Ahmed, Peer-e-Kamil

Poverty and the US Economy Essay

Today, there are developed, emerging and developing countries in the world. A larger percentage of people live under extreme poverty in most developing countries. In most developed countries poverty exist, but a lower proportion. Most developing countries formulate policies either monetary or fiscal to reduce the prevalence of poverty. However, there is no country without a policy options for elimination poverty. In a broader sense, poverty cannot be eradicated, but can be reduced to a certain level. This is why countries are pursuing various polices that could help reduce poverty in their region. Fiscal and monetary policies are the main tools used in formulating various strategies, actions that aim to reduce poverty. This issue leads us to poverty issue in the United States of America. Then, what are the various policies that can be used to eliminate poverty in the country. Should the policy makers make use of fiscal or monetary policy? Subsequently, what policy tools will be used, fiscal or monetary? In this write up there will be a comprehensive analysis on what policy option that should enacted to eliminate poverty in the USA. To begin with, understanding what fiscal and monetary policy entails is necessary. Then, what is fiscal policy? In a simple term, fiscal policy refers to an effort by the government to manage, influence and guide the tempo or direction of the economy by using its major tools taxation and its total spending. There are two major tools of fiscal policy, which are taxation and government spending. In addition, there could be contractionary or expansionary fiscal policy. Expansionary fiscal policy here means when there is increase in government spending or reduction in taxation. This normally leads to budget deficit and vice versa. While, monetary policy refers to an effort by the government to change the pace of the economy by influencing or controlling the money supply and interest rates. These various policies are pursued by government in other to achieve the basic economic objectives of full employment, stability in price level and growth of the economy. However, in the US the fiscal or monetary policies have to be enacted in other to reduce or eliminate poverty. In performing this task, different things have to be put in their rightful place. Even though, poverty cannot be eliminated from the country yet with a very good fiscal and monetary policies it proportion could be reduce. The reason why I believe poverty cannot be completely eliminated is because of the way economy and nation evolves. From time immemorial, there have been some certain classes of people in the economy. They range from upper, middle and lower classes. In any economy, there will always be the lower class and this comprises of the people living below the poverty line. In addition, there will always be those at the receiving end. Africa can be a very good example of this issue. Therefore, there is way how we would not have poverty in any nation. What can only be done is to reduce drastically the number. In country like the US, the poverty rate can be reduced to a small level if government pursues good monetary and fiscal policies. The government could enact fiscal, monetary policies and both together in the economy to reduce the poverty rate. These would be explained as follows: Firstly, we are going to consider the fiscal policy. Since, our main aim is to reduce the level of poverty. The government could pursue both the contractionary or expansionary fiscal policy. However, global financial crises have an overall effect on the nation’s economy. Moreover, the US government could enact contractionary policy to reduce the level of inflation. Since, the tools of fiscal policy are taxation and government spending. The government should reduce its spending and increase the tax of the elite and the upper class in the nation only. When this is done, the government will have more funds, which could be spent on increasing the aggregate demand of the lower class or people living below the poverty line. In a way the real income of the lower class will be increased through this policy, since the funds will be redistribute from the rich to the poor. In a way, there is the effect that fiscal policy has on the nation at large and on the individual as a whole. In as much as our focus relates to individual then, we pursue those action that will be beneficial to the individual rather than the whole nation. In addition, when government pursue budget deficit the economy is receiving less than what its expend. In this case, the government will have to finance this deficit using different approaches. They could borrow the populace or sell assets. Sale of asset may include the sale of bonds and treasury bills in other to offset the deficit. Treasury bills and bond are example of government tools use to reduce the money in circulation. Government sells these to the public in other to remove money in circulation. This money needed will be gotten from the upper class or the rich by increasing their tax. On the other hand, an expansionary fiscal policy could also be enacted. Here, the government should reduce the tax of the lower class and government should increase their spending on economic activities that could increase aggregate demand of this lower class and result in increased productivity. When government takes this action, the real income or the disposable income of this class of people would increase and thereby increasing their purchasing power. Given that, disposable income is the income that is left for spending when tax has been removed from income. In addition, when government increases their spending they pursue budget deficit. Here, they should incur these funds on economic activities that could increase the productivity and aggregate demand of the lower class. When there is increase in government spending, it means that the government is redistributing its asset to its populace. Thereby increasing total productivity in the economy and leading to increase in total income. This increase in total income will trickle down to the lower class and increase their disposable income. In essence, when government pursues the basic economic objective, they will be solving the issue of eliminating poverty indirectly. Therefore, the government could use fiscal policy in reducing the level of poverty in the nation However, the government in pursuing this objective of eliminating poverty can also use monetary policy. They could also use expansionary monetary policy. In a way, contractionary monetary policy will not be effective in achieving this objective. When they wish to use expansionary policy, the government should influence the interest rate by reducing it using its various tools. When this happens, investment will increase leading to increase in productivity that will trickle down to the lower class. Since, increasing productivity more labor effort would be require in achieving this. Then, there will be increase in employment that will trickle down to the lower class. In a way, more people will be employed and this will include the lower class. This situation will increase the real income of the lower class and will enable them live above the poverty line. However, the contractionary monetary policy will not be effective in this case. Since, under this policy there will be reduction in the rate of interest and consequently leading to decrease in productivity. When productivity is reduced, it means inventory is reducing and companies are sacking workers and this most times affects the lower class. Therefore, this will further worsen poverty situation in the country and contributing to increase in the level of unemployment. In another way, the government could combine both fiscal and monetary policies in other to achieve their objective of eliminating poverty in the country. What is needed is the right combination in other to guide against inflation. The government could influence the interest rate and at the same time enact policy that would make lower income earners pay reduce tax or used to offset the feedback from these policy option. The government could also combine expansionary monetary and fiscal contractionary policies in a way to offset any feedback from this policy options. In conclusion, there are ways the government of the United States of America could use to eliminate poverty. However, we should have it in mind that poverty cannot be eliminated permanently in the country. It could only be reduce to its barest minimum. In a way, the government actions are very vital. The two main policies to be enacted are the monetary and the fiscal policy. Finally, I think the global financial crises have a way of influencing the way these policies will work.