Friday, December 27, 2019
Obesity Factors Associated With Type 2 Diabetes - 956 Words
Obesity remains one of the leading factors associated with Type 2 Diabetes. Type 2 Diabetes, previously identified as Adult-Onset Diabetes, affects the way one metabolizes glucose, a crucial energy source for the body. Type 2 Diabetes also causes an increase or decrease in insulin production. Insulin resistance occurs when the body prohibits the usage of insulin. According to the Center for Disease Control (CDC), Type 2 Diabetes ââ¬Å"accounts for 90 to 95 percent of diabetic casesâ⬠; making it the prominent form of diabetes. The CDC indicates Type 2 Diabetes results from a combination of genetic and environmental influences (2014 National Diabetes Statistics Report.). Obesity, a significant risk factor, enhances the effects of Type 2 Diabetes leading to liver disease and pancreatitis. The lack of muscle mass also contributes to Type 2 Diabetes, making it difficult for the elimination of glucose from the body. Excess levels of fat heighten inflammation in the body, changing the way it reacts and responds to insulin. The additional levels of fat stimulate inflammation throughout the body. Described by Vivian Fonseca, MD, inflammation, first targets adipose or fat cell; acting comparable to a protective mechanism, preventing the body from losing motility and dying (Vann). Juan F. Navarro and Carmen Mora, students from Oxford University stated, ââ¬Å"In obesity, activation starts from the process of pro-inflammatory cytokines [proteins] such as tumor necrosis factor-à ±, interleukin-1à ²Show MoreRelatedObesity Is Prevalent Between Children And Adolescents In1177 Words à |à 5 PagesObesity is prevalent between children and adolescents in the United States. Obesity is the second leading cause of death after smoking in the US. It also causes cancer, and it is associated with unhealthy eating and less exercise or physical activity. The concerns of childhood and adolescent obesity include earlier puberty and menarche in girls, type 2 diabetes and increased rate of the metabolic disease in adolesce nce and adults. Therefore, the rate of obesity has increased in the American childrenRead MoreDiabetes in the Latino Community1648 Words à |à 7 PagesIntroduction Diabetes is a prevalent health disparity among the Latino population. Diabetes is listed as the fifth leading cause of death among the Latino population in the website for Center for Disease Control and Prevention, CDC, in 2009. According to McBean, ââ¬Å"the 2001 prevalence among Hispanics was significantly higher than among blacks.â⬠(2317) In other words among the Hispanic or Latino community, there is a higher occurrence of diabetes as compared to other racial/ethnic groups such as BlacksRead MoreExamining Diabetes and Metabolic Traits of Mexican Americans in the AIR Registry Sample1308 Words à |à 5 Pagescontributions to diabetes and metabolic traits in the AIR registry sample, which is composed of Mexican American participants who reside in the Phoenix-Arizona area. The AIR registry participants were extensively phenotyped for type 2 diabetes and metabolic syndrome measures. The prevalence of diabetes in our population was 12.3%, which was above the 8.3% of the gene ral population [32,33]. Moreover, we observed that 34.0% of the participants were classified with pre-diabetes, which was similarRead MoreResearch Paper On Diabetes957 Words à |à 4 PagesDiabetes ââ¬â Global trend Modern Medicine has been witnessing serious challenges from four non-communicable diseases (Cardiovascular; Chronic Respiratory conditions; Cancer and Diabetes) which are often associated with unhealthy lifestyle choices (lack of physical activity, smoking, alcohol misuse and unhealthy dietary habits)1. Diseases which were once associated with the first world, have become a global problem. Prevalence of Diabetes has risen to an epidemic proportion and the UK has not been immuneRead MoreObesity As A Disease Essay1378 Words à |à 6 Pages(36.5%) of adults in the United States are obese. Obesity is defined as a weight that is higher than what is considered as a healthy weight. Body Mass Index (BMI) is used as a screening tool for overweight and obesity. According to the World Health Organization, worldwide obesity has nearly doubled since 1980. In 2016, 39% of women and 29% of men over the age of 18 were overweight. Today, around one in five children, ages 6-19 are obese. The obesity epidemic only continues to worsen in the United StatesRead MoreObesity : A Serious Health Condition1452 Words à |à 6 PagesObesity is a serious health condition that, if left untreated, causes serious health conditions. Contrary to popular belief, obesity is more than a condition caused by overeating and lack of exercise (Vallor 2013). Obesity is a disease (Callahan 2013); a disease that Americans are spending about $150 billion on annually (Zamosky 2013). Additionally, changing a personââ¬â¢s diet and exercise regimen may not be effective in some cases of obesity (Vallor 2013). Obesity is not like most well-known diseases;Read MoreObesity : Obesity And Obesity1413 Words à |à 6 Pagesmore than 1.5 billion people that are overweight worldwide (2). There are more than 280 million people around the world that have been diagnosed with diabetes, resulting in at least 1 in 20 adults (2,8). Currently, diabetes is ranked as the seventh overall cause of death in the United Stat es (9). In 2010, on 69,071 death certificates in the United States, diabetes was listed as the underlying cause, and in 234,051 death certificates, diabetes was mentioned as a cause of death (6). The Centers for DiseaseRead MoreObesity : Obesity And Obesity Essay1169 Words à |à 5 PagesObesity Obesity refers to excess body fat while overweight refers to excess body weight in terms of excess fat, muscles, bone or water. According to the National Health and Nutrition Examination Survey (NHANES) (2009ââ¬â2010), about 69% of the adult population in the U.S. is overweight or obese, with more than 78 million adults being obese. Consistent with the survey, at least 2 in 3 adults are overweight or obese and more than 1 in 3 adults are obese. In addition, more than 1 in 20 adults in the URead MoreCauses Of Type 2 Diabetes And Obesity1484 Words à |à 6 Pagesreport highlights the main causes of Type 2 Diabetes and the association between diabetes and obesity in adults. The report also discusses the associated health implications for those people who have been diagnosed with this disease and some of the long term affects on health. CONTENTS Introduction 4 Causes of Type 2 Diabetes 4 Risk Factors for Diabetes 4 Consequences of Diabetes 4 Health Implications 5 Symptoms of Type 2 Diabetes 5 Management of Diabetes 5 Costs to the NHS 6 Health ImprovementRead MoreMaternal Obesity Induce Offspring with Risk of Cardiovascular Disease1700 Words à |à 7 PagesMaternal obesity induce offspring with risk of cardiovascular disease Introduction: The rate of obesity for the human population has shown to be increased expeditiously in the past decades. It has continuously raised health concerns among the world, and is likely to remain in times to come. This phenomenon is primarily due to the lifestyle changes resulting in high-energy intake coupling with decreased physical activity (Cameron et al. 2003). Obesity is identified by the high adipose tissue,
Thursday, December 19, 2019
Financial Statements Used By Decision Makers - 1559 Words
Introduction This essay will begin to look at the main financial statements used by decision makers in businesses today. This essay will go into detail about the income statement and statement of financial position and whether these two statements provide decision makers with their financial information adequately. This essay will also include the various advantages and disadvantages of each financial statement as well as describing whom the decision makers are and why financial statements are important to them. A conclusion will be present at the end of this essay to demonstrate an overall view of whether financial statements are beneficial to decision makers. Financial accounting is a crucial process for any successful business. Atrill and McLaney, 2013 define financial accounting as: ââ¬Å"the identification, measurement and communication of accounting information for external users (those users other than the managers of the business).â⬠Financial Statements It is importan t for every business to carry out financial statement analysis in order to gain an understanding of their current financial status. There are two main types of financial statements that businesses commonly use when it comes to financial analysis. These are known as the Profit and Loss Account and the Statement of Financial Position. A profit and loss account consists of a list of expenses incurred by the company, against their revenues over a certain period of time. It shows whether the organisationShow MoreRelatedInternational Accounting Standard Board ( Iasb )1454 Words à |à 6 PagesInternational Accounting Standard Board (IASB) is a professional body that develops and approves International Financial Reporting Standards (IFRSs). The IASB is known as an independent and a private sector organizational. IASB was formed to replace the International Accounting Standard Committee. The IASB organization is responsible for all technical matters of the IFRS Foundation that includes â⠬Ëfull discretion in developing and pursuing its technical agenda, subject to certain consultation requirementsRead MoreApplication For Making An Organization Context1719 Words à |à 7 Pagesappropriate formats for decision making in an organization context 3.1 Demonstrate collected data and information through various graphs using any statistical software e.g. spreadsheet Using spreadsheet, decision makers record their information in rows and column so that data can be presented in graph using MS excel. For quick review of information and easy understanding, business organization uses spreadsheet line. Now, spreadsheet line, pie chart, bar chart will be used to analyze information.Read MoreWhy Are Accurate Financial Statements Important for Outside Business Interests1432 Words à |à 6 PagesWhy are accurate financial statements important for outside business interests? Matt ACC 205: Principles of Accounting I Professor Kaplan Ashford University December 22, 2011 Accounting is specifically ââ¬Å"a system by which economic information is identified, recorded, summarized and reported for the use of decision makersâ⬠; however, accounting involves interpretation and analyzing of all financial information, including taxing, personal financial information and investment (AlbaRead MoreQualitative Characteristics of Accounting Information846 Words à |à 4 Pagesprovided in financial statements useful to users. The four principal qualitative characteristics are understandability, relevance, reliability and comparability. It is also pointed out that these qualitative characteristics may need to be balanced against one another. (John Wiley Sons Australia, Ltd, 2009) The relative importance of the characteristics in different cases is a matter of professional judgment. Relevance Relevance refers to the information provided with the statements of users associatedRead MoreDo The Requirements Of Ifrs 8 Operating Segments Enhance Quality Of Information Available For Financial Statement Users?1744 Words à |à 7 PagesDo the requirements of IFRS 8 Operating Segments enhance the quality of information available to financial statement users? Introduction The IFRS 8 is an international accounting standard, which requires entity, adopt management method when report operating segmentsââ¬â¢ financial performance to made the segmental information closer to the internal report of the entity. The IASB has substituted IFRS 8 for IAS 14 and combined the segment report request with the SFAS 131Read MoreContemporary Issues Of Accounting ( Theory ) Essay1216 Words à |à 5 PagesContemporary Issues in Accounting (Theory) One of the most debatable or contentious issues in the accounting is measurement. While the objective of general purpose financial reporting is to generate information that is beneficial to decision makers external to the organization, there is no agreement on the most appropriate measurement to use. The various stakeholders in this field continue to disagree on the most suitable measurement model to use to achieve the objective of general purpose accountingRead MoreFinancial Accounting And Managerial Accounting1613 Words à |à 7 PagesIntroduction: Both financial accounting and managerial accounting provide important information about the business process. On the one hand, financial accounting provides only financial information to its internal users and external users. On the other hand, managerial accounting basically communicates about financial and non-financial information with internal users such as managers, employees and owners of the company. In other words, managerial accounting provides information to managers who directRead MoreAccounting. Aasa 8 Operating Segment1141 Words à |à 5 Pagesmanagementââ¬â¢ approach to an entityââ¬â¢s reporting of information relating to its operating segments in annual financial reports, and also requires an entity to report financial and descriptive information about its reportable segments. AASB 8 is applicable to for-profit entities whose debt or equity securities are traded in a public market and to entities in the process of filing financial statements for the purpose of issuing such instruments. Slide 2 An entity may comprise one or more operatingRead MoreThe Decision Criteria For Payback904 Words à |à 4 Pagesfor the project in Italy). iii)Payback period for Switzerland = 4years + 20/50x12 = 4years + 5months ( this is the amount of time required to recover the initial project in Switzerland). The decision criteria for payback project to be accepted is the project with the shortest number of years. Bi) ARR for Germany= Average profit/investment = 20+30+40+15+5/5 x 100 100 Read MoreAuditing, Attestation, and Assurance Services Paper - Introduction1077 Words à |à 5 Pagesexplain what standards apply to each service and who establishes those standards. Comparing and Contrasting Auditing, Attestation, and Assurance Services Auditing is the term used to describe the process of obtaining objective evidence regarding the reliability and integrity of financial information or statements (Elliott Pallais, 1997).à à It includes procedures such as testing systems and gathering evidence.à à Inquiry is another important procedure in addition to analytical tests of records
Wednesday, December 11, 2019
Grade 12 Physics Daniel Gockeritz Essay Example For Students
Grade 12 Physics Daniel Gockeritz Essay PRACTICAL INVESTIGATION MOMENTUM AND COLLISIONSThis report will investigate the theoretical velocity of a ball bearing gun. The methods and techniques used to derive the results will be shown along with the possible systematic and random errors caused by experimental limitations. Discussion:? Since the track is virtually frictionless and air resistance is neglected, the system is isolated; the net resultant force of the external forces equals zero. ? The total linear momentum of the system before the collision is equal to the total momentum after the collision. Therefore, the total change in momentum of this two-particle system is zero. ? Equation that represents the conservation of momentum:? The total linear momentum of an isolated system is constant. ? All significant experimental errors have been incorporated into the final velocity result. Aim:To investigate and determine the muzzle velocity of a ball bearing gun by utilizing the law of conservation of momentum. Determine out the theoretical velocity using various mathematical methods and techniques. Hypothesis:This two-particle system is virtually isolated, thus the total change in momentum is zero. Therefore when the two bodies collide, they will exert forces on each other, equal in magnitude but opposite in direction. Resulting in one combined body that is equal to the sum of the momentum of the two particles before the collision. Materials:? One (1) Ball bearing. (Weight 65.9g 0.1, Approx Size 2cm in diameter)This will be the projectile that is fired from the missile launcher. ? One (1) Cart. (Weight 678.3g 0.1)This will be the object on which the projectile is fired onto. ? One (1) standard Stopwatch. (Can measure up to 100th of a second)Used to time the journey of Cart + ball bearing. ? One (1) Track. (Measuring device length 0.50m 0.05)Used to guide cart and measure displacement. Method/Procedure:1. Prepare track by aligning it and the cart to a perfect 180 degrees to the launcher. ? Distance used was 0.50m 0.05. 2. Fire the ball bearing into the cart and time the journey. ? The ball bearing used in this experiment, took an average of 1.14 0.1 seconds to complete 0.50 meters. 3. Work out the theoretical velocity of the ball bearing in the barrel of the launcher. ? Equations used to determine theoretical final velocity:NOTE: During entire experiment, safety glasses are to be worn. Any spectator that is not wearing safety glasses should watch from a safe distance. Results:Errors accounted for:? Parallax Error: 0.05m? Stopwatch/Timing Error: 0.1s? Mass measurement error: 0.1gRecorded measurements (NOT including uncertainty):Times for overall journey: 1.13s, 1.13s, and 1.16sDistance: 0.50mMass of Ball Bearing: 65.9gMass of Cart: 678.3gTo determine average time (NOT including uncertainty):To determine mass of combined body after collision:To determine velocity of combined body after collision:s = 0.50m 0.05 t = 1.14s 0.1s = 0.50m 10% t = 1.14 8.7%To determine velocity of ball bearing in barrel of missile launcher:The muzzle velocity of this ball bearing gun is:. Errors not incorporated into method:? The ball beating itself has a small drag coefficient, although the cart, which the ball bearing is fired into, may experience air friction. ? All air friction/resistance was neglected. Conclusion:This experiment proved my hypothesis correct. Throughout the entire experiment the overall change in momentum equaled zero. When the two particles collided there momentum was conserved resulting in one body that was the combined mass and momentum of the previous bodies. The result was obtained by recognizing that the initial velocity/momentum of the ball bearing could be determined by utilizing the conservation of momentum law; that as long as the net resultant external forces equal zero, the momentum will be constant. From this exercise I learnt new method and techniques used in calculating errors and uncertainty. .u7eb3e4e7cdf25d67500a99cb0ad0fffe , .u7eb3e4e7cdf25d67500a99cb0ad0fffe .postImageUrl , .u7eb3e4e7cdf25d67500a99cb0ad0fffe .centered-text-area { min-height: 80px; position: relative; } .u7eb3e4e7cdf25d67500a99cb0ad0fffe , .u7eb3e4e7cdf25d67500a99cb0ad0fffe:hover , .u7eb3e4e7cdf25d67500a99cb0ad0fffe:visited , .u7eb3e4e7cdf25d67500a99cb0ad0fffe:active { border:0!important; } .u7eb3e4e7cdf25d67500a99cb0ad0fffe .clearfix:after { content: ""; display: table; clear: both; } .u7eb3e4e7cdf25d67500a99cb0ad0fffe { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u7eb3e4e7cdf25d67500a99cb0ad0fffe:active , .u7eb3e4e7cdf25d67500a99cb0ad0fffe:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u7eb3e4e7cdf25d67500a99cb0ad0fffe .centered-text-area { width: 100%; position: relative ; } .u7eb3e4e7cdf25d67500a99cb0ad0fffe .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u7eb3e4e7cdf25d67500a99cb0ad0fffe .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u7eb3e4e7cdf25d67500a99cb0ad0fffe .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u7eb3e4e7cdf25d67500a99cb0ad0fffe:hover .ctaButton { background-color: #34495E!important; } .u7eb3e4e7cdf25d67500a99cb0ad0fffe .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u7eb3e4e7cdf25d67500a99cb0ad0fffe .u7eb3e4e7cdf25d67500a99cb0ad0fffe-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u7eb3e4e7cdf25d67500a99cb0ad0fffe:after { content: ""; display: block; clear: both; } READ: In Cold Blood Review EssayBibliographyPhysics Investigation on Momentum and collisions
Tuesday, December 3, 2019
To the Memory of Mr. Oldham Essay Example
To the Memory of Mr. Oldham Paper Oldies verse, rough and unrefined, In comparison o Dryness style begs the question, why did Dryden want to pay tribute to a much younger and less accomplished poet? In the first ten lines of the elegy we can see that Dryden attempts to establish the history between the two. Too little and too lately known , shows us that the two authors had Just recently met and Whom began to think to call my own, tells us that John Dryden had started to take a Liking to John Lolled. This fact Is elaborated on by the sentence For sure our souls were near lady: and thing cast in the same poetic mould with mine. Dryden says here hat their souls were really close to each other and they were cast from the same poetic mould. It is interesting on Dryness part to say this when their styles were not so similar, Dryden being artistic and flowing and Oldies style seemingly coarse and less thought through. However, we are told that they did know each other in the first ten lines so we must take another route in determining why Dryden wanted to lament Oldies passing. We will write a custom essay sample on To the Memory of Mr. Oldham specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on To the Memory of Mr. Oldham specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on To the Memory of Mr. Oldham specifically for you FOR ONLY $16.38 $13.9/page Hire Writer In lines nine and ten we see that Dryden may be stating that Lolled was a stepping stone in Dryness studies. Thus Minus fell upon the lippies place, while his young friend performed and won the race. This couplet illuminates Dryness way of thinking. It seems that Dryden learned a little from John Lolled despite his young age, which probably attributes to Dryden liking Lolled, and this spurred Dryden on to new heights, so he relates Oldies death to Missuss fall and Dryden himself is the young friend who wins the race. However, this is not to say that Dryden used Lolled in a negative way. In the legend, Minus was winning the race when he slipped in a pool of blood and fell; he then rolled into the path off avail opponent so that his friend could win the race. So, in essence, he is saying that Lolled helped him to achieve greater heights in writing and fame even though Lolled died, or fell. All this probably attributes to the reason for John Dryden to write the tribute to Lolled, however, the elegy does not stop there. In lines ten through fourteen, Dryden ponders on what older age could have given Lolled In terms of higher thinking and achievement. This part Is sort of a wishful thinking attempt at contemplating what John Lolled would do In older age. Dryden states that age might have given Lolled a refined tongue for his harsh and rugged line. Another answer to the reason Dryden felt Like he owed a tribute to Lolled Is that he may have felt that John Lolled was a man before his time. In lines nineteen and twenty Dryden writes Thy generous fruits, though gathered ere their prime still showed a quickness; and maturing time. This meaning that the fruits of Oldies labor, his poetry and satires, were mature for Lolled. Also, In answer to ten to ten shuttles Dryden en uses ten words allele Ana mould, n s basically comparing himself to Lolled. This is not strange because they have the same birthday, and they both write in satire, Just different styles in satire. When he writes One common note on either lyre did strike and knaves and fools we both abhorred alike, Dryden is comparing both he and Lolled to how musicians are similar when they play the lyre in reference to their poetry. Although, he does criticize Oldies verses in that he says thro the harsh cadence of a rugged line, a noble error, and but seldom made, when poets are by too much force betrayed. He is criticizing Oldies work here saying that his errors are noble and that he himself writes satire in better verses. The piece where he mentions the rugged line probably indicates that Lolled is more preoccupied with the matter that is given rather than the manner in which it is given. This view is expressed more clearly when Dryden writes But mellows what we write to the dull sweets of rhyme. Overall, we see that John Dryden and John Lolled had many things in common. They were both poets, or satirists to be more exact, and they both had the same airhead. Yet Lolled was substantially less famous than Dryden and had accomplished considerably less than him, so this begs the question why did Dryden feel the necessity to write a tribute to him? As we have seen, Dryden feels that he was connected to Lolled, maybe it is that they were both satirists, maybe it is that Lolled castigated wickedness instead of preaching virtue and Dryden found this appealing. Or maybe, Dryden saw Lolled as an equal, not on a literal level, but on a metaphoric, by this I mean that Lolled wrote satires in a way that was before his mime seeing that he was only 30 at the time of his death. It is for this reason, I believe, that Dryden feels he must at least recognize the young writer so that people may not forget what could have been had not smallpox prematurely ended Oldies life. He equates him with Marcella, the son-in-law of the Emperor Augustus. Marcella died at an early age and he was mourned very heavily by the Roman population, and Dryden uses this to pay tribute to Lolled who will more than likely not be mourned widely by the masses.
Wednesday, November 27, 2019
A Girl Making Bikes Fly Professor Ramos Blog
A Girl Making Bikes Fly I never imagined that a girl like me would be on a dirt bike, flying up in the air and racing against a bunch of boys. I never thought I could do it or thought I had it in me to be so fearless, or so strong. When everyone thinks of riding motorcycles or doing anything dangerous they think that itââ¬â¢s a man doing it. I was a girl who weighed 120lbs and had never ridden my life. Growing up my dad and my older brother both had dirt bikes, and every year took trips out to the desert when riding season came around, and every year I wanted to go with them, but they wouldnââ¬â¢t let me. I would always ask my dad if I could get a bike of my own, but he never wanted his fragile precious daughter to ride a motorbike and hurt herself. When I got older and was able to make decisions on my own, a boyfriend I had at the time, had a dirt bike and would go to a track that was nearby and ride or race when they had racing events. One day he invited me out to the track to watch a race. I had never been to a track before or even knew they were around. When we got there, he explained to me there were a few different tracks that had different levels. There was the beginner, intermediate and the main track. The main track was the hardest and had the biggest jumps, and these were the kind of jumps that if you didnââ¬â¢t land where you were supposed to, you were most likely going to land in the hospital. When I got out of the truck I was so excited, all I could hear was the motors. These people were going as fast as they could, trying to pass each other and souring through the air jumping these huge jumps, and as they went around turns dirt was flying from their back tires. I had never seen anything like it, other than on th e tv. à Out with all of the them, I saw this bad ass chick riding a dirt bike jumping all the same jumps they were, I thought that was so awesome, I wanted to go out there so bad and ride with her. They all made it look so easy, and I thought if she could do it, so could I. I was so stuck on that day, literally two weeks later I went out and got a dirt bike, a CRF 250. Now, the first time I rode it was definitely not on the track or else I wouldââ¬â¢ve been murdered from getting ran over by everyone riding, or just hurt myself because I had no idea what I was doing. So, we took the bikes up to some land his parents owned, and he began to teach me. I started off slow, and when I say slow I mean I was totally afraid to take my feet off the ground and go. à Plus, the bike was tall and heavy, so I was on my tip toes trying to keep it up, I probably looked like a teeter totter. If you donââ¬â¢t have the muscle memory, or just muscle in general, its really easy to tip over. So, there was a lot of falling down without even going anywhere. Eventually, I got a hang of taking my feet off of the ground and at least moving. We went to his parents land a few more times to practice so that when It came time to go to the track I could at least ride without kil ling myself. When it came time to go to the track I was so nervous. As you can imagine, I started on the beginnerââ¬â¢s track. The beginners track was the easiest, it was smaller than the rest and all the jumps were tabletops. Tabletops are exactly how they sound, they look like tables, theyre jumps where you could jump on top of it, or jump the whole thing and land in the landing. Well, I rolled over them, as these little kids on their tiny bikes flew by me like I was standing still. I was definitely a fish out of water. While I had my boyfriend on his bike riding next to me yelling out ââ¬Å"leanâ⬠! or ââ¬Å"Fasterâ⬠! encouraging me to ride better. One of the next times we went, I finally built up the courage to go faster over a jump and I actually got the bike off of the ground. I ran to my boyfriend and yelled ââ¬Å"I finally did itâ⬠. Now, it might have just been a few inches off the ground, but I was so happy. We started to go a lot more and I would practice and practic e. Eventually, I was able to jump the whole jump! I was obsessed with the rush. After going so much, I was able to ride the whole beginners track and was ready to move on to the intermediate track which was à harder. On that track I had to start over again, rolling jumps and slowly turn without tipping over. Sometimes, I would get frustrated from not being able to jump the jumps since they were a lot bigger, there was a lot more people, and the track was more strategic.. à The biggest jumps on that track were both tabletops, one was about 30 ft and the other was a little bigger. I tried to jump them but would end up just jumping on top of the face of it, too afraid of going so fast and didnââ¬â¢t want to hurt myself. My boyfriend told me that if I wanted to jump it, I was going to have to go faster, to get it out of second gear and pin it, so thatââ¬â¢s what I did. I came at the jump in third gear and cleared it! I eventually ended up clearing both the big jumps and was able to ride the à whole rest of the track without a breeze. I fell in love with it so much, I started loading up my bike up and go to the track by myself. One day I heard there was going to be a race held at the track, so I decided to enter it. I entered menââ¬â¢s beginner. I was so nervous that day and the days before it. I remember gearing up, riding my bike to the starting gate, almost having a heart attack.à But I was ready, the gates went down and off we went. I rode as fast as I could I jumped all of the jumps and finished all five laps, I felt so accomplished, I ended up last, but I still felt accomplished. I did not care at all that I got last, all I wanted to do is say I raced and finished! A few month later à ended up in another race, signing up for the menââ¬â¢s beginners à and womenââ¬â¢s beginners . In menââ¬â¢s I ended up beating one of the guys. I actually almost landed on him because he didnââ¬â¢t jump one of those big table tops. He shouldââ¬â¢ve pinned it. He wasnââ¬â¢t too happy that I beat him, but I sure was. And I ended up getting first in the womenââ¬â¢s race. Now whenever I tell anyone I rode dirt bikes they look at me funny, because they would have never expected me ââ¬Å"a girlâ⬠to do anything so crazy, or dangerous. But they also thought it was pretty awesome. I proved that I could do anything I wanted to do, even if i am a girl. Thanks to that bad ass chick I saw out there riding, I became one myself. Sorry Dad, Iââ¬â¢m not so fragile after all.
Saturday, November 23, 2019
Thesis Format
Thesis Format Thesis Format Thesis Format Headlines help organize your thesis format more effectively. Headlines help you choose an appropriate thesis format.Ã Thesis format is not set; it is very flexible and can be changed in the process of thesis writing.Ã The sequence of headings, in turn, establishes the development of the argument throughout the thesis. There are many levels of headings and there is uniform rule to use.Ã However, you should keep in that your thesis dissertation writing should have at least some consistency.Ã Generally, chapter titles are marked as 'Heading 1' (perhaps upper-case, bold, and centered), the main ideas of each chapter are marked as 'Heading 2' (perhaps title case, bold, and left aligned) and sub-headings are marked as 'Heading 3' (perhaps italic and left-aligned). The greatest prominence is given to the most important headings, using combinations of capital letters (upper case), centering, and bolding. When you are working on a thesis chapter of 10,000 words, it can become difficult to check whether there is an overall consistent flow in what you are writing. For example, material on page 19 might follow material on page 3 more logically, but (unless you are continually re-reading the whole thesis and concentrating carefully) you might miss an overlap or lack of logical flow. An excellent way to check the flow of a thesis chapter is to check the headings. Outline view is invaluable when you are working on large documents such as thesis writing with multiple headings. Writing a thesis is a complex work, and if you have no possibility to write a thesis, you can take advantages of custom thesis services. Thesis Format Tips We advise you to spend some time talking with your tutor over requirements and expectations.Ã Thesis dissertation writing is a very large project and you definitely want to make it right.Ã It is a challenge as well as an opportunity to produce an original and interesting piece of writing.Ã Your thesis paper might determine your career choice and even shape the professional growth.Ã Do not miss an opportunity to get professional assistance with your thesis writing. .com You are welcome to order custom thesis writing service at our site.Ã Years of writing and editing experience give us confidence to promise qualitative assistance.Ã We can write a good thesis for you.Ã You will not regret placing an order at our site because we fulfill all of our promises!Ã Free plagiarism report and unlimited revisions upon request!
Thursday, November 21, 2019
The evolution of strategic intelligence analysis beginning in WWII Essay
The evolution of strategic intelligence analysis beginning in WWII trhough the Korean war - Essay Example Strategic intelligence involves acquiring information pertaining to military strategy and operation plans at the national level. In strategy intelligence, more focus is shifted on factors such as geography of foreign countries, long-term future planning trends and tactics. According to the DIA, strategic intelligence is a crucial implement in anticipation of future threats globally (Andrew 45). The World War II made America to realize the need for military intelligence in particular in terms of strategy. According to the Defense Intelligence Strategy (DIA), the Pearl Harbor attack by the Japans came as a huge surprise to the U.S presumably as result of inability or total failure by the government to predict the attack (Defense intelligence Agency). This is considered as one of the most noteworthy intelligence letdowns that subsequently led to the evolution of strategic intelligence. In the awakening of the Second World War, Andrew points out that the U.S. faced what he termed as a re volution in intelligence. In his opinion, both former presidents Truman and Roosevelt were incapable of grasping the full repercussions of the revolution. Roosevelt was, however, interested in human intelligence that was more spy-based instead of signal intelligence such as radio transmitter (Defense intelligence Agency). ... to an American and British Treaty that saw to the authorization and subsequent commencement of the development of the covert operations that were to gather relevant military information (Andrew). This also set up the foundation for the formation of government intelligence units such as the Central Intelligence Agency (CIA) as well as National Intelligence Agency (NSA). This was further augmented by Eisenhower who greatly contributed towards the development of strategic intelligence especially imagery satellites in an era where space explorations had not been launched. To do this, through the CIA Eisenhower deployed U-2 panes that surveyed the U.S. borders as well as some parts of the enemiesââ¬â¢ territories (Prouty and Ventura 42). According to Prouty and Ventura, these steps marked a significant evolution of intelligence as the CIA started to invade areas that it was familiar with and in which it could establish its operations without being seen or observed by other parties with in the U.S. government as well as other enemies. Prouty and Ventura describes the CIAââ¬â¢s activities as a water spillage that spread quite fast. By the late fortes, the U.S. Air Intelligence Force was established by General Vandenberg that consisted of a number of units that was well equipped with military weaponry ranging from flight machineries to printing correspondents and leaflets distribution units. Upon their establishment, they were taken through a rigorous during training exercise, before being deployed to various parts of the world such as Japan. Some aspects of these units were greatly incorporated in the Korean War with some of the specialized sections made to work with the CIA in Asia, the Middle East and Europe as well (Johnson 163). Strategic intelligence was further boosted by
Wednesday, November 20, 2019
Economic Perspectives Of Global Warming Case Study
Economic Perspectives Of Global Warming - Case Study Example Global Warming and Climate Change have now become the buzzwords and rightly too. Carbon Dioxide released from the burning of fuels especially fossil fuels is a significant contributor to the global warming effect. The ever-increasing concentration has been held responsible for the breaking of Arctic Ice Caps; the retreat of glaciers, increase in salinity, storms, floods and so forth. In short, the results could be catastrophic for civilization as we know it. Greenhouse gases tend to stay put before they dissipate. While the jury is still out on the ways to tackle this problem, there is no doubt that economic trade-offs will be involved. Economics provides the necessary tools to realistically address the problem. "It's really now a battle over the economics," said James E. Rogers, chief executive of Duke Energy, who has long advocated curbing carbon emissions. "The debate is not about the climate problem. Everybody could agree on the principles and still get the economics wrong." ( NYT 6th, June 2008 ) The least cost option, as identified by economists, is one which increases reductions over the decades. This will allow for capital depreciation and also the replacement of conventional energy sources like coal, fuel oil, etc. with alternative sources like wind, solar power, Nuclear Power and the like. It is no coincidence that China and India are among the major sources for greenhouse emissions have been under pressure from the OECD and the Group of Eight to look at alternative energy sources. Neither is any altruism involved. Economics dictate adoption of a pragmatic approach which would be all inclusive i.e. include the developed and developing countries (who are way below emission levels in the developed economies and still in an economic growth path with no incentive to cut down on such emissions). Climate is perceived as a public good and therefore international cooperation is de rigueur.
Sunday, November 17, 2019
The Drink of a Real Man Essay Example for Free
The Drink of a Real Man Essay What makes a man? Is it ruggedness and toughness? Is it dominance and patriotism? Does a man drink only the hardest liquor to prove his manhood? Jim Beam thinks so. In the depths of this Jim Bean Bourbon advertisement lies a stereotype in American society that is inaccurate. Through the language of colors, font, and actual text, men get an idea of what a real man should be. A ââ¬Å"real manâ⬠should have the qualities of bravery and toughness. Men are constantly pressured by society to act tough for people to respect them. A real man would drink Jim Beam Bourbon rather than a flavorful drink that tastes good. The real definition of a man, in Jim Beamââ¬â¢s case, is a dominant, strong human being. The message the advertisement promotes constrict men by denying the variety of qualities any man might possess and further advocates the stereotype of how men have to be tough in order to be considered a real man. At first glance, you notice the massive, bold, white font in the middle of the compelling advertisement. It is near impossible to avoid this writing because the letters pop out at you. On the left side of the advertisement, the bold lettering reads ââ¬Å"President Truman Drinks a Glass of Bourbon Every Day, and on the right side of the ad continues, ââ¬Å"Then He Kicked The Commies Out of South Korea. These words imply several different meanings in the text itself. The advertisement refers to President Truman as a symbol of patriotism and independence. The ad condones ââ¬Å"kicking the commies out of South Koreaâ⬠because Jim Beam is patriotic and wants independence. The text illustrates a cause and effect chart; President Truman drinks bourbon every day, the effect is he gained manhood and patriotism, and kicked the communists out of South Korea. This advertisement purposely chooses to promote the ââ¬Å"goodâ⬠qualities of manhood, which include masculinity, sturdiness, and toughness. The colors in the advertisement display masculinity as the background has an aged wood look mixed with some colors of brown, white, black, copper, and sea green. These colors are dull and attract the male eye because of its manly color scheme. On the left half of the advertisement there is a picture of an eagle carved into a wooden slab. The wood is very uneven and rugged, to symbolize how a man is also rugged and emotionally rough. The eagle is Americaââ¬â¢s national bird; it represents a symbol of freedom and patriotism. Through this eagle alone, the advertisement promotes patriotism and the idea that real men who drink Jim Beam Bourbon are patriotic, just as President Truman did. The eagle is also a symbol for strength and courage, two characteristics that a ââ¬Å"real manâ⬠must possess. The right side of the page displays a Jim Beam bottle of bourbon with a wall of old, antique pictures hanging up slightly faded in the background. The picture that most stands out is the one of the owl on the far right, which symbolizes perfect wisdom, in this case, the wisdom for a man to pick Jim Beam Bourbon over any other alcohol brand. The picture of the actual bourbon bottle is slightly hidden behind the text that reads ââ¬Å"Then He Kicked The Commies Out of South Koreaâ⬠, and is placed in the middle of a wooden table. The placement of the bourbon bottle could represent stability and strength, which is what America was built on. This advertisement is very pleasing to men because it makes them feel strong and patriotic and Jim Beam bourbon can define them as ââ¬Å"real menâ⬠. This advertisement appeals to almost every American man old enough to drink, specifically the men who love this country and the idea that American men can conquer any situation. The subtext under the bottle on the right half of the advertisement reads, ââ¬Å"Bourbon is Americaââ¬â¢s official native spirit. Jim Beam is the number one bourbon in the world. Maybe thatââ¬â¢s because since 1975 weââ¬â¢ve been about the stuff inside. TheStuffInside.comâ⬠. The text comforts you because it claims bourbon is the official native spirit of America and Jim Beam is the number one bourbon in the world providing a sense of security. This allows Americans to drink Jim Beam and know that their country made this and allows them to appreciate the patriotism that comes with it. For this reason, the words ââ¬Å"Weââ¬â¢ve been about the stuff inside,â⬠are significant as well because they have a double meaning. They can mean the actual bourbon contained in the glass bottle itself, or the strength and the characteristics of what makes a man on the inside. Jim Beam will help men feel strong because they are drinking the bourbon that President Truman drank to beat the communists. Men who see this advertisement will think that drinking Jim Beam bourbon will make them feel more important, more patriotic, and more masculine. What these men will not see is the advertisement is not only selling the item for consumption, but also selling ideas about American culture. Underneath the colors, underneath the font, underneath the pictures, this advertisement is essentially selling the idea that the perfect man must be strong, patriotic, aggressive, and dominate. This ad reinforces this stereotype of men, insisting that there is only one kind of man that can actually be called a real man. This real man is forcibly strong, patriotic, and tough. Overall, the advertisement conveyed itââ¬â¢s message about how strong, patriotic American men drink Jim Beam Bourbon, but it does not take into consideration the remaining population of American men who are not strong or patriotic.
Friday, November 15, 2019
Role of the Human Resource Manager
Role of the Human Resource Manager Executive Summary The following report has discussed about the role of Mr. John Edwards, Human resource manager of Reliance Communication Ltd. The report focuses on the responsibilities and complexity of a person who is performing the role of a human resource manager. Interaction of Mr. Edwards as a human resource manager with other departments of the organization and with people outside the department is also discussed. The report begins with introduction to human resource management and highlights its importance in every business. Introduction is followed by a brief summary of the company. The report provides an analysis of the role of Mr. Edwards, what his priorities are and what he should do to be more effective in his job. The report is concluded with key points discussed in the report and is followed by references. Introduction The focus of Human Resource Management (HRM) is on managing people within the employer-employee relationship. It involves the productive use of people in achieving the organizations strategic business objectives and the satisfaction of individual employee needs (Stone, 2008). The competitive advantage for organizations in the old economy centered on the financial capital and technology, the emerging economy has shifted its emphasis on investment in human capital, knowledge and the commitment of the employees. The focus in the business world has shifted from physical assets to knowledge and information capital. The effective management of human capital poses new challenges in the organisation for leadership and managerial capabilities. The human resource function has gone from the traditional hire and fire role to a strategic partner with finance, operations and other business departments that are not centers of profit for the organization. The job of HR, as is the job of all such departments, is to ensure that the business gets the most out of its employees. In another words, the human resource management needs to provide a high return on the businesss investment in its people. This makes it a highly complex function (Cascio, 1998). The following discussion is all about that is discussed above. Discussion will surround around involvement of Mr. Edwards in the company and how he is developing assets for his company. Company Profile Reliance Communications (formerly Reliance Infocomm), along with Reliance Telecom and Flag Telecom, is part of Reliance Communications Ventures (RCoVL). It is an Indian telecommunications company. Reliance Communications is a leader in telecommunications products and consultancy, a privately owned company with over 20 years of service to the business community, and with a reputation for integrity, superior implementation and support. Anil Dhirubhai Ambani controls 66.77 per cent of the company, which accounts for more than 1.36 billion shares. It is the flagship company of the Reliance-Anil Dhirubhai Ambani Group, Reliance Energy, Reliance Capital and telecom initiatives of the Reliance ADAG (Company profile). Role of HR Manager Staffing: Key function of Mr. Edwards is to fulfill staffing needs of the company and it can be done in variety of ways, whether to use independent contractors or hire employees to fill these needs. It takes place in two three steps. First step is to identify the requirements of the company and what kind of requirements is being requested. Second step is to determine the number of people and the skills mix necessary to do the work. Final step is to recruit and select the people best suited for the job and then to train them to fit and work efficiently in the organization. Retention: one of his critical roles in todays environment must be to help keep, develop and motivate the good people with scarce skills. This, of course, means knowing who they are and making sure that sufficient time and attention is spent with them. He makes sure that employees are rewarded for performing their jobs effectively, so as to keep them motivated. To make them comfortable he ensures that harmonious relations are maintained between the employees and the company and to maintain a safe and healthy work environment. Managing change: The constant evaluation of the effectiveness of the organization results in the need for the HR manager to frequently manage change. Both knowledge about and the ability to execute successful change strategies make him exceptionally valued. He acts as a change agent, serving as a catalyst for change within the organization. He has achieved this by developing problem solving communication and influence skills. He Advise managers on organizational policy matters such as equal employment opportunity and sexual harassment, and recommend needed changes. Employee Advocate: He acts as an advocate to every employee working in his company, to makes them aware of every information they require. It is his duty to provide current and prospective employees with information about policies, job duties, working conditions, wages, and opportunities for promotion and employee benefits. Serve as a link between management and employees by handling questions, and administering contracts and helping resol ve work-related problems interpreting. Analyze training needs to design employee development, language training and health and safety programs (Dolezalek, 2008). Development: is a function in which his objective is to preserve and enhance employee competence in their jobs through improving their knowledge, skills, abilities and other characteristics. Other functions: Analyze and modify compensation and benefits policies to establish competitive programs and ensure compliance with legal requirements. Plan and conduct new employee orientation to foster positive attitude toward organizational objectives. Maintain records and compile statistical reports concerning personnel-related data such as hires, transfers, performance appraisals and absenteeism rates. Analyze statistical data and reports to identify and determine causes of personnel problems and develop recommendations for improvement of organizations personnel policies and practices. Plan, organize, direct, control or coordinate the personnel, training, or labor relations activities of an organization. Conduct exit interviews to identify reasons for employee termination (Hofstede, 1980). Responsibilities of Mr. J. Edwards Tasks What he Do What he Doesnt Do Skills Required Skills not Required Provide expert guidance, perspective, and support to enable managers and supervisors to make appropriate pay decisions Yes Communicate programs and guidelines to help managers and supervisors understand all aspects of the compensation program Yes Identify, collect, and analyze external market data in order to ensure alignment Yes Maintain the competitiveness of the staff compensation structure by reviewing the market trends annually and, when appropriate, making adjustments to the structure to reflect market pay levels Yes Evaluate and determine appropriate job family, level, title, exempt/non-exempt classification and salary range for each new position and for each request for reclassification Yes Hiring, supervising, training, monitoring and firing of staff. Yes Maintain performance management tools for each staff position on campus Yes Ensure compliance with applicable laws and regulations Yes Effective communication Yes Ethical behaviour Yes Persuasiveness and the ability to influence others. Yes Strategic thinking and critical/analytical thinking Yes Organizational skills Yes Interdependencies Human resource manager works with different types of people and groups within and outside the organisations. Without interacting with these groups he wont be able to do achieve his goals with efficiency. Thus he is very much interdependent on these groups to bring the best out of him and the people his is supervising. Following chart shows the various departments he is related to: = outside organisation = within organisation Top management: HR manager links the employee with the company. If there is demand made by the employees such as change in pay structure, working conditions or resolving disputes between them, he gets in touch with the management and tries to resolve the issue as soon as possible. In return top management sets the guidelines and objectives which are to be followed by the employees. He makes sure that if there is any change in the guidelines for the employees, they are implemented. Sales department: sales department of Reliance communication is very big and have different branches. There are sales people who manage the sales process and there are others who complete the sale. Both the branches require people with different skills. Sales department will inform the HR manger about their requirements for personnel and it is the responsibility of Mr. Edwards to fulfill it on time. He may do it by directly recruiting people or if it is an emergency, he may approach any recruiting agency t o meet his requirements. Production Department: He maintains a constant touch with the production manager and provides him with staff that is required to fulfill the department. In this case it is his duty to guide employees of workplace safety and other safety measures. Marketing Department: Mr. Edwards play a very important role when dealing with the marketing department. He not only recruits people for them but also discusses the need of skills that are feasible for promoting the company and accordingly sets out the criterion for selection. Accounts department: he prepares an estimated budget, which will be required for the purpose of hiring and training new employees. In return he hires people for the accounts department when required. There are few interactions which are similar with every department. He takes initiative to motivate employees in every department and makes sure that he is in constant touch with employees who are facing any problems or having any issues while working. He sets up programs at regular basis to interact with employees of every department to know their problems and inform them if there are any changes required by the top management (Mujteba, 2006). Recruiting agencies: he contacts these agencies when there is an urgent need to employ people and it is not viable to go through the process of recruitment because of its time consuming feature. He will inform them with his requirements and in return they will provide with people of required skills. Conclusion The role of the HR manager must parallel the needs of his or her changing organization. Successful organizations are becoming more adaptive, resilient, quick to change direction and customer-centered. Within this environment, the HR manager, who is considered necessary by line managers, is a strategic partner, an employee sponsor or advocate and a change mentor. According to Dickson (1998), most important function of HR manager is to provide a support system to its employees; it can be emotional or physical. In todays organizations, to guarantee their viability and ability to contribute, HR managers need to think of themselves as strategic partners. In this role, the HR person contributes to the development of and the accomplishment of the organization-wide business plan and objectives. The HR manager contributes to the organization by constantly assessing the effectiveness of the HR function. He also sponsors change in other departments and in work practices. To promote the overall success of his organization, he champions the identification of the organizational mission, vision, values, goals and action plans. Finally, he helps determine the measures that will tell his organization how well it is succeeding in all of this. Managing people is one of the most difficult aspects of organizational management; it means dealing with people who differ physically and psychologically (Mendenhall, 2007). References: ïÆ' ¼ Stone, R. J., (2008). Human Resource Management, 6th edition. Pg. 3. John Wiley publication. ïÆ' ¼ Dickson, R. (1998). Huaman Resource Management 2. Retrieved from http://www2.prestel.co.uk/rossticle/essays.htm, retrieved on 12th August, 2009. ïÆ' ¼ Company Profile. Retrieved from www.reliancecommunications.com. Retrieved on 12 August, 2009. ïÆ' ¼ Cascio, W. F. (1998). Managing Human Resources. Pg 46. Irwin McGraw Hill. ïÆ' ¼ Hofstede, G. (1980). Cultures consequences: International differences in work-related values. Beverly Hills, CA: Sage Publications. ïÆ' ¼ Mendenhall, Mark E.; Oddou, Gary R.; and Stahl, Gunter K. (2007). Readings and Cases is International Human Resource Management 4th ed. Routledge Publishers, Taylor Francis Books. ïÆ' ¼ Mujtaba, B. G. (2006). Cross Cultural Change Management. Llumina Press, Tamarac, Florida. ïÆ' ¼ Dolezalek, H. (2008). Good Job! Training, 45(6), pp. 32-34.
Tuesday, November 12, 2019
For The Love of Junk Food
Everybody have an uncontrollable weakness to a certain type of junk food. That desirable craving you have to satisfy right then and there. Being able to binge once you see a platter or buffet table with all the junk food in the world, we just donââ¬â¢t like the idea of eating increments at a time. We as a society like the idea of a quick cheap fix whenever hunger comes over us. Instead of either taking leftovers from last nightââ¬â¢s dinner, or getting up extra early before work or school to fix a proper breakfast, or pack a proper lunch, we rather go to the local corner store to pick up two Twix bars and a sprite to hold us over. We love taking the easy way out of things. In the article, Is Junk Food Really Cheaper? , the author Mark Bittman targets the difficult topic of how people make excuses that eating healthier is way more expensive than just taking a family of four plus people to a local fast food restaurant. Bittman made his target audience families that are somewhat busy with extra-curricular things. For Bittman to help his targeted audience he went out to local stores and did price comparisons and he also did surveyââ¬â¢s on why parents would rather choose a twenty piece nugget from Mc Donaldââ¬â¢s over a hot healthy home-cooked meal. Bittman, the Brooklyn, New York native, is a NY Times Opinion columnist. ( Bittmanââ¬â¢s Minimalist column was in the dining section of NY Times for over thirteen plus years. He holds the title of being the lead columnist for the Times Dining section and also the lead food writer for The Times Magazine. Bittman graduated from Clark University with a bachelor degree in psychology. Bittman is the author of fifteen cookbooks. He is married with two adult daughters. Not only is Bittman a writer but he is also a chef. Since Bittman has had experience with feeding a family of four in the past he can understand why some families would rather eat out than fix a meal, but he still feels that there should not be an excuse to cook dinner at least once or twice a week. Bittman explains how our society not only make prices an excuse for eating unhealthy but he also explains how we as people say that cooking is too time consuming after a long day of work. In this article, Bittman seem to approach the issue with anger because of the many excuses given for not making a proper meal for the family. He threw in facts and opinions of everyday people that deal with these kinds of decisions. Being a chef and a father of two, Bittman understands the importance of cooking a healthy meal and sitting it on the table. Bittman stated that ââ¬Å"the core problem is that cooking is defined as work, and fast food is both a pleasure and a crutch. (Bittman)â⬠That sentence alone explains why most parents do not come home and cook for the family. They feel as if itââ¬â¢s another job. Bittman argued in the article that though it may seem as if buying processed and junk food is cheaper, itââ¬â¢s really not! He gave an example of having a family of four and going to Mc Donaldââ¬â¢s buying each person a meal. The total of the meal came out to be approximately thirty dollars. If the parents were to go to the local grocery store and buy a roast and broccoli, the total will only end up being fourteen dollars. Bittman also brings attention to how over the years the inflation price of fresh produce has gone up while for fast-food restaurants it has decreased. This brings more attention towards spending money on unhealthy food. Bittman stated in the article ââ¬Å"that overconsumption of fast food ââ¬Å"triggers addiction-like neuroaddictive responsesâ⬠in the brain, making it harder to trigger the release of dopamine. In other words the more fast food we eat, the more we need to give us pleasure; thus the report suggests that the same mechanisms underlie drug addiction and obesity. (Bittman)â⬠Bittman grasp the audience attention by letting them know that eventually their bad habits of taking the easy way out will catch up to them and harm them. Putting themselves in grave danger of potentially, letââ¬â¢s say, having a stroke or even dead maybe. Itââ¬â¢s noticeable in the article that Bittman is fed up with the excuses. Bittmanââ¬â¢s article is very relatable because he is basing it on average households around the world. Bittman wrote this article to target families that take the easy way out. Though this article is intended for families, single people, and couples should also take heed to the information given. Eating healthier is how you keep yourself looking and feeling young. Bittmanââ¬â¢s purpose of this article is to inform everyone that eating take out every night is unhealthy and that there should be no excuse as to why a person cannot come home and cook a decent meal. Bittman encourage families across the nation to challenge themselves into cooking more than usual. Bittman wan this readers to understand that cooking once a week is better than not cooking at all, he also want them to see that cooking can be enjoyable. He doesnââ¬â¢t want his readerââ¬â¢s to think that cooking is a hassle and a burden to get accomplished. Mark Bittmanââ¬â¢s article, Is Junk Food Really Cheaper, made such a bold entrance and informative ending that it came and conquered the message. Bittman put enough facts into this article that it should definitely make a person think twice about feeding their family take-out food two nights in a row. The details of the articles flowed with bold points along with opinions from Bittman and others. It was like Bittman came to the podium and laid it all on the table. Bittman gave several examples on how eating out is more expensive than cooking a meal throughout this article. Since Bittman is a family man he knew what components to insert in this article to grasp the attention of his targeted audience. This article was straight forward and to the point. Though Bittman went in about the topic from the very beginning he never lost his focus on what he was coming to execute. If Bittmanââ¬â¢s article, Is Junk Food Really Cheap, can grasp hold of my attention as a college student he can very well grasp the attention of a parent that wants to keep their family live and healthy.
Sunday, November 10, 2019
The Cask of Amontillado
The Cask of Amontilladoâ⬠Unexpected Endings In ââ¬Å"The Cask Of Amontilladoâ⬠there are several themes shown throughout the short story. There are only two main characters in the story, and each shows their way of betrayal. The entire story is based on betrayal, and lies. Fortunado is betrayed by Monresor, who in the end, kills this intoxicated man. Montresor was supposedly betrayed by Fortunado, a story of which we are never told. Finally, we as the reader are betrayed by the narrator, because we are given so few details and logic to back up the story.Fortunado, Montresor, and the reader are betrayed throughout the short story, ââ¬Å"The Cask Of Amontilladoâ⬠. Throughout the story, Montresor betrays Fortunado. He asks Fortunado to come into his catacombs aware that he would be killing him. He taunts Fortunado by asking him if he want to go back, because he is sick. Montresor does so when saying ââ¬Å"ââ¬ËCome,ââ¬â¢ I said, with decision, ââ¬Ëwe will go b ack; your health is preciousâ⬠¦Ã¢â¬â¢Ã¢â¬ (Poe 535) However, when Fortunado insists he comes to taste the amontillado, he is once again betrayed by Montresor when he drinks more of his wine.He becomes overly intoxicated and once again, is able to be taken advantage of. The entire walk through the catacombs Montresor betrays Fortunado by lying to him and taunting him about being sick. At the end of the story Montresor traps Fortunado by building him into a small shackled space. ââ¬Å"A succession of loud and shrill screams, bursting suddenly from the throat of the chained form, seemed to thrust me back violentlyâ⬠(Poe 536). According to Chad Dyer ââ¬Å"The story is written in the form of confession, its reader learning of Montresourââ¬â¢s vengeful deed fifty years after its execution. â⬠(Dyer).When Montresor kills Fortunando he commits not only a huge crime but a betrayal that is unbelievable to most people. Furtunado is a simpler, less obvious betrayer. He is mentioned in the very beginning cause a ââ¬Å"thousand injuriesâ⬠(Poe 533) causing Montresor to ââ¬Å"vow upon revengeâ⬠(Poe 533). Despite all the wrongdoing of Montresor, Fotunado was the beginning, and cause of it all. ââ¬Å"It must be understood, that neither by word nor deed had I given Fortunado cause to doubt my good willâ⬠(Poe 533). As the editorial team on Shmoop claims, ââ¬Å"Fortunado betrays himself by not paying enough attention to his surroundingsâ⬠. Shmoop Editorial Team). Fortunado was so severely intoxicated he didnââ¬â¢t stop to notice the dead bodies surrounding him in the catacombs, not the fact that he was with a man he has never been friendly with. He allowed himself to continually drink from the wine his enemy was providing without even the thought that it could be deadly. In the beginning of the story, Montresor tells us ââ¬Å"The thousand injuries of Furtunado I had borne as best I couldâ⬠¦ â⬠(Poe 533) We however ar e never given any type of proof of what Fortunado had done to hurt Montrsor as much as he claims.We are never given an explanation, or even a slight clue of the wrongdoing Fortunado had caused. This leaves one to suggest that maybe the narrator was telling us a complete lie. The story was written to keep us guessing. Throughout the entire walk through the catacombs, we had no clue what they were truly walking through. We were given vague descriptions of the bodies lining the walls. When he describes building the brick wall to trap Furtunado, he describes it in a very undetailed description. Montresor shows betrayal, as well as Fortunado, and the narrator.This proves it to be a common theme throughout the story. It is shown through Montresor when he betrays Fortunado multiple times. When he kills Fortunado, he lies to him throughout the story, and plans to kill him before he even agrees to drink wine with him. Fortunadoââ¬â¢s betrayal, although never explained, is the beginning of all the betrayal throughout the story. He has hurt Montresor in a way so badly Montresor feels his only escape it to kill Fortunado. As the reader were betrayed throughout the entire story.We are told multiple things throughout the story, but nothing is ever proven. We have to assume the narrator is telling us the truth. The theme betrayal is shown dramatically through Poeââ¬â¢s eyes.Works Cited Dyer, Chad M. Edgar Allen Poes The Cask Of Amontillado. Diss. Ball State, 1992. N. p. : n. p. , n. d. Web. <https://cardinalscholar. bsu. edu/bitstream/handle/190175/1/D94_1991DyerChadM. pdf>. Poe, Edgar A. The Compact Bedford Introduction to Literature. Boston: Bedford/St. Martin's, 2003. Print. Riggs, Kait. The Cask of Amontillado Irony Analysis of ââ¬Å"The Cask of Amontilladoâ⬠In ââ¬Å"The Cask of Amontilladoâ⬠by Edgar Allan Poe, the main character named Montresor is set out for revenge. Montresorââ¬â¢s only concern is to get revenge on the man who has wronged him named Fortuanto. Montresor never states why Fortunato deserves to be punished. The only statement Montresor makes is that Fortunato ââ¬Å"causes him a thousand injuriesâ⬠until ââ¬Å"venturing upon insult. â⬠(Poe, Online) Montresor plans to take out his revenge by burying Fortunato alive. Montresor carries out each detail while he smiles at his victim.Montresor doesnââ¬â¢t smile at the thought of Fortunatoââ¬â¢s ââ¬Å"immolationâ⬠but because of viciousness. (Sweet Jr. Online) Montresor smiles because he believes the sacrifice of Fortunato will bring him a great reward. Fortunato is ironically the ââ¬Å"mirror selfâ⬠of Montresor (Sweet Jr. Online). Montresorââ¬â¢s desire to bury Fortunato alive â â¬Å"paints the psychological portrait of repressionâ⬠(Sweet Jr. Online). The burial of Fortunato represses Montresorââ¬â¢s evil nature and puts him at peace. In ââ¬Å"The Cask of Amontillado,â⬠Edgar Allan Poe uses irony to develop his theme of seeking salvation through repression.Poe uses Fortunatoââ¬â¢s name ironically to symbolize one personality between Montresor and Fortunato. Though Fortunato means ââ¬Å"the fortunate oneâ⬠in Italian, Fortuanto meets an unfortunate fate as the victim Montresorââ¬â¢s overall revenge plot. (Stott, Online) Therefore, the Fortunato side of Montresor symbolizes fortune. Montresorââ¬â¢s desire is to repress Fortunato. Since ââ¬Å"the love of money is the root of all evils,â⬠a fortune would ââ¬Å"plunge a man into ruin and destructionâ⬠(1Timothy 6:9-10). The Fortunato side of Montresorââ¬â¢s personality wants to have wealth.The wealth Fortunato receives makes him both respected and feared. (Poe, Online ) By having wealth, Fortunato causes Montresor ââ¬Å"a thousand injuriesâ⬠(Poe, Online). When Fortunatoââ¬â¢s wealth gains the fear of others, he ââ¬Å"ventures upon insulting Godâ⬠(Poe, Online). When a ââ¬Å"man seeks greed for gain, he curses and renounces the Lordâ⬠(Psalms 10:3). Montresor needs to repress Fortunato to protect his soul from damnation. (Stott, Online) The only way Montresor can protect himself is to get rid of Fortunato. Montresor can repress the aspect of his personality which insults God by burying Fortunato alive.Fortunato, ironically despite his name, faces a very unfortunate fate at the hands of Montresor. Montresorââ¬â¢s name translation similar to Fortunatoââ¬â¢s in two ways. In French Montresorââ¬â¢s name ââ¬Å"combines the words montrer and sort meaning to show fateâ⬠(Clendenning, Online). Montresor shows Fortunato his fate but Fortunato ââ¬Å"receives no utterance to a threatâ⬠about his fate. (Poe, Online) Wh en Montresor shows Fortunato his fate of being buried alive it demonstrates that Fortunatoââ¬â¢s live burial is an act of repression. The second French translation for Montersor is ââ¬Å"my treasureâ⬠.Through punishing Fortunato Montresor believes he can have the treasure of purity and salvation. Fortunatoââ¬â¢s dress is ironic for a man with his stature in society. Fortunato is a man with stature who is ââ¬Å"rich, respected, and admiredâ⬠(Poe, Online). Fortunato wears a ââ¬Å"tight-fitting parti-striped dress, and his head is surmounted by the conical cap and bellsâ⬠for the carnival. â⬠(Poe, Online). Instead of the cap representing Christââ¬â¢s crown of thorns, the cap represents Satanââ¬â¢s role as ââ¬Å"Prince of Foolsâ⬠(Pittman, Online).Through the sacrifice of Jesus Christ, Christians were able to receive salvation. Through Fortunatoââ¬â¢s sacrifice, Montresor will seek salvation. Montresor dresses more like a priest for the carn ival season. ââ¬Å"Montresorââ¬â¢s black roquelaire symbolizes a priestââ¬â¢s black cope worn during a funeral mass. â⬠(Cooney, Online) Montresor dresses for the occasion that he is going to bury Fortunato. Montresorââ¬â¢s attire suggests that the repression of Fortunato will have an important spiritual reward. Through the repression of Fortunato, Montresor will reach salvation.The carnival setting ironically suggests a time for sin. ââ¬Å"The carnival season consists of the last indulgences in the pleasures of the fleshâ⬠(Pittman, Online). Fortunatoââ¬â¢s sin of abundantly drinking makes Montresorââ¬Ës plan easy to carry out. ââ¬Å"The word carnival can be translated in Italian meaning to put away the flesh which demonstrates symbolic irony of Montresorââ¬â¢s intent for Fortunatoâ⬠(Clendenning, Online). Montresor can make himself free of sin and worthy of salvation by repressing the sinfulness of Fortunato. The catacombs are an ironic symbol o f the way Montresor thinks.The repression begins when Montresor takes Fortunato into his family catacombs with the promise of Amontillado wine. The catacombs are ââ¬Å"lined with human remainsâ⬠and that suggests generational family troubles (Poe, Online). Fortunato keeps going farther and farther into the catacombs with only his sinful thoughts of being able to drink more wine, not knowing he is moving closer and closer to his fate of being buried alive. The wall symbolizes the finish of the repression of Fortunato. ââ¬Å"Ironically, the wall forms Fortunatoââ¬â¢s burial crypt. (Sweet Jr. , Online) Salvation can only happen when sins are repented. Once Fortunato yells ââ¬Å"For the love of God, Montresor! ,â⬠Montresor says ââ¬Å"Yes, . . . for the love of God! â⬠(Poe, Online). Montresor believes that Fortunatoââ¬â¢s repression shows his love for God and demonstrates Montresor reaching salvation. The cask symbolizes a confession. Montresor tells the story fifty years later in a confession tone. ââ¬Å"When Montresor says, ââ¬Å"You, who so well know the nature of my soul,â⬠he implies a priest receives his confessionâ⬠(Sweet Jr. , Online).Montresor believes that Fortunatoââ¬â¢s burial was done in good. Montresor has no remorse as he confesses but, he still confesses. ââ¬Å"Montresorââ¬â¢s conscience knows Fortunatoââ¬â¢s burial is an evil deed. â⬠(Sweet Jr. , Online) Montresor ends by saying ââ¬Å"In pace requiescatâ⬠(Poe, Online). ââ¬Å"Montresorââ¬â¢s prayer suggests that he desires relief from guilt, not forgiveness for a crimeâ⬠(Sweet Jr. 11). The feeling of salvation Montresor seeks through his confession doesnââ¬Ët happen. ââ¬Å"For a confession to receive absolution, the confessor must demonstrate the conviction of remorse. (Sweet Jr. , Online) Montresor is unable to achieve the salvation he seeks through the repression of Fortunato. The Amontillado symbolizes Christââ¬â¢s bl ood in communion. Christââ¬â¢s blood offers the salvation that Montresor seeks. The Amontillado may lead Fortunato to his burial but it symbolizes the salvation Montresor wants to gain through repression. Fortunato wants to drink the wine out of pride and lust while Montresor sees the wine as something that brings him the bond of communion and the reward of salvation.Edgar Allan Poeââ¬â¢s uses ironic symbols throughout ââ¬Å"The Cask of Amontillado. â⬠The ironic symbols helped him develop the theme of seeking salvation through repression. Fortunatoââ¬â¢s character was able to represent manââ¬â¢s flesh and how people easily give in to the sins of the flesh while Montresor represents how man seeks salvation through acts of repression. Fortunato represents the side of Montresor that should confess but Montresor chooses to bury Fortunato which leads to the failure of his own salvation. The Cask of Amontillado The Cask of Amontilladoâ⬠Unexpected Endings In ââ¬Å"The Cask Of Amontilladoâ⬠there are several themes shown throughout the short story. There are only two main characters in the story, and each shows their way of betrayal. The entire story is based on betrayal, and lies. Fortunado is betrayed by Monresor, who in the end, kills this intoxicated man. Montresor was supposedly betrayed by Fortunado, a story of which we are never told. Finally, we as the reader are betrayed by the narrator, because we are given so few details and logic to back up the story.Fortunado, Montresor, and the reader are betrayed throughout the short story, ââ¬Å"The Cask Of Amontilladoâ⬠. Throughout the story, Montresor betrays Fortunado. He asks Fortunado to come into his catacombs aware that he would be killing him. He taunts Fortunado by asking him if he want to go back, because he is sick. Montresor does so when saying ââ¬Å"ââ¬ËCome,ââ¬â¢ I said, with decision, ââ¬Ëwe will go b ack; your health is preciousâ⬠¦Ã¢â¬â¢Ã¢â¬ (Poe 535) However, when Fortunado insists he comes to taste the amontillado, he is once again betrayed by Montresor when he drinks more of his wine.He becomes overly intoxicated and once again, is able to be taken advantage of. The entire walk through the catacombs Montresor betrays Fortunado by lying to him and taunting him about being sick. At the end of the story Montresor traps Fortunado by building him into a small shackled space. ââ¬Å"A succession of loud and shrill screams, bursting suddenly from the throat of the chained form, seemed to thrust me back violentlyâ⬠(Poe 536). According to Chad Dyer ââ¬Å"The story is written in the form of confession, its reader learning of Montresourââ¬â¢s vengeful deed fifty years after its execution. â⬠(Dyer).When Montresor kills Fortunando he commits not only a huge crime but a betrayal that is unbelievable to most people. Furtunado is a simpler, less obvious betrayer. He is mentioned in the very beginning cause a ââ¬Å"thousand injuriesâ⬠(Poe 533) causing Montresor to ââ¬Å"vow upon revengeâ⬠(Poe 533). Despite all the wrongdoing of Montresor, Fotunado was the beginning, and cause of it all. ââ¬Å"It must be understood, that neither by word nor deed had I given Fortunado cause to doubt my good willâ⬠(Poe 533). As the editorial team on Shmoop claims, ââ¬Å"Fortunado betrays himself by not paying enough attention to his surroundingsâ⬠. Shmoop Editorial Team). Fortunado was so severely intoxicated he didnââ¬â¢t stop to notice the dead bodies surrounding him in the catacombs, not the fact that he was with a man he has never been friendly with. He allowed himself to continually drink from the wine his enemy was providing without even the thought that it could be deadly. In the beginning of the story, Montresor tells us ââ¬Å"The thousand injuries of Furtunado I had borne as best I couldâ⬠¦ â⬠(Poe 533) We however ar e never given any type of proof of what Fortunado had done to hurt Montrsor as much as he claims.We are never given an explanation, or even a slight clue of the wrongdoing Fortunado had caused. This leaves one to suggest that maybe the narrator was telling us a complete lie. The story was written to keep us guessing. Throughout the entire walk through the catacombs, we had no clue what they were truly walking through. We were given vague descriptions of the bodies lining the walls. When he describes building the brick wall to trap Furtunado, he describes it in a very undetailed description. Montresor shows betrayal, as well as Fortunado, and the narrator.This proves it to be a common theme throughout the story. It is shown through Montresor when he betrays Fortunado multiple times. When he kills Fortunado, he lies to him throughout the story, and plans to kill him before he even agrees to drink wine with him. Fortunadoââ¬â¢s betrayal, although never explained, is the beginning of all the betrayal throughout the story. He has hurt Montresor in a way so badly Montresor feels his only escape it to kill Fortunado. As the reader were betrayed throughout the entire story.We are told multiple things throughout the story, but nothing is ever proven. We have to assume the narrator is telling us the truth. The theme betrayal is shown dramatically through Poeââ¬â¢s eyes.Works Cited Dyer, Chad M. Edgar Allen Poes The Cask Of Amontillado. Diss. Ball State, 1992. N. p. : n. p. , n. d. Web. <https://cardinalscholar. bsu. edu/bitstream/handle/190175/1/D94_1991DyerChadM. pdf>. Poe, Edgar A. The Compact Bedford Introduction to Literature. Boston: Bedford/St. Martin's, 2003. Print. Riggs, Kait.
Friday, November 8, 2019
Assessing The accomplishments of Galileo Galilei Essay Example
Assessing The accomplishments of Galileo Galilei Essay Example Assessing The accomplishments of Galileo Galilei Paper Assessing The accomplishments of Galileo Galilei Paper In the field of scientific discipline, Galileo Galilei is good known by the universe for detecting the Torahs of neglecting organic structures and gestures of missiles ; open uping telescopic observation and detecting maculas, the irregular surface of the Moon, the orbiters of Jupiter, and the stages of Venus. Most of all, he besides contributed to defending Copernicus Sun-centered existence and motivating the split that freed scientific cognition from the limitations of religious belief. There are uncountable achievements made by him. Now we give his life narrative and how it began. Galileo Galilei was born in Pisa, Italy on February 15, 1564, and he was the oldest of seven kids. His male parent, Vincenzo Galilei, who instigated his ain revolution in the humanistic disciplines by challenging the current theories on the construction of music, believed that medical specialty would be the best profession for his boy. However, Galileo had told his male parent that he wanted to be a monastic. This was non what his male parent had in head, so Galileo was taken off from the monastery. In 1581, at the age of 17, he entered the University of Pisa to analyze medical specialty, as his male parent wished. At that clip, Galileo discovered something that no 1 else had of all time realized: The jurisprudence of the pendulum, and that made Galileo immediately celebrated. Galileo Galilei so moved on to the University of Padua, and started to larn his existent involvements, mathematics and mechanics. In 1590, Galileo made a two ball while landing, at the tower of Pisa, this celebrated experiment, corrected Aristotle s theory of the falling object is relative to the velocity and weight, which continued for 1900 Old ages of incorrect conclusionsListenRead phonetically. In the twelvemonth 1592, Galileo entered the University of Padua to analyze mathematics, where he stayed for 18 old ages. Since so, Galileo ushered in the aureate age of life. Galileo stayed at the Palace in Florence to go on scientific research, but his astronomical finds and his Hagiographas clearly reflected astronomy out of the Copernican heliocentric position. Thus, Galileo began to have the church s attending. In 1610, Galileo published a book, The Starry Messenger, depicting his findings that supported the Copernican theory. Galileo s support for the heliocentric theory got him into problem with the Roman Catholic Church. He was forced to abandon his astronomical chases. From 1616, Galileo accused by the Roman Inquisition and began over 20 old ages of barbarous persecution. But, Galileo retaliated by printing a book subsequently on, Dialogue Refering the Two Chief World Systems. This book cause more statements with the church due to it were in Italian which was a direct struggle with the church. Galileo s ulterior life is really suffering, taking attention of his girl Sailisite even before he died. The unhappiness of losing his girl made Galileo blind. Even in such conditions, he still did non give up his scientific research. January 8, 1642, 4:00, for scientific discipline, for truth and life of the soldiers fight, Galileo passed off at the age of 78 old ages. Died on the Eve of his going, he repeated the phrase: the chase of scientific discipline requires a particular bravery. During 18 old ages of working in Padua University, Galileo ab initio concentrate on the mechanics he had been interested in research, he discovered an of import phenomenon in natural philosophies inactiveness of the motion of objects ; did the celebrated angle pattern summed up the objects from falling through with the relationship between the figure of clip ; He besides studied the shells of the run, laid the theoretical footing of the parabola ; on the construct of acceleration, but besides made his first clear: even to mensurate a patient with febrility when the temperature increases, the celebrated physicist, invented in 1593 is besides the first air thermometer. However, an inadvertent event made Galileo changed the research way. He turned to mechanics and natural philosophies of the expansive infinite of the huge sweep. Galileo telescope was invented.It was June 1609, Galileo heard of intelligence that the Dutch man of affairs has spectacless found in the occasional in the dis tance with a lens to see unseeable things. Is this non precisely what I need clairvoyance it? Galileo was really happy. Soon, a pupil of Galileo s wrote him a missive from Paris, to further corroborate the truth of this information, the missive said the spectacless made a by the man of affairs decidedly a mirror tubing, utilizing it can do magnified the object many times. Galileo began to pull a diagram and an imagination lens. This prompted the mirror control Galileo was inspired, it seems that the secret to amplify objects through mirror tubing is to take the right sort of lens, in peculiar, convex and concave to fit. He got the information about the lens and continued to cipher. After a whole dark, Galileo eventually understand that the convex and concave lenses in a proper distance, as the Dutch saw it, the distant object the bare oculus can non see can be seen when magnified. Galileo attended to rest and rapidly started crunching lenses, this is a really time-consuming and requires carefulness occupation. He did good for several yearss, a brace of convex and concave lens crunching, and so produced an luxuriant two-tier metal tubing which can skid. Galileo carefully put a bigger one terminal of the tubing lens safety, the other terminal of the arrangement of a smaller concave lens, and so put the tubing in forepart of the window. When he looked fr om one terminal concave, miracle appears, the church seemed distant sight, he could clearly see the cross on the tower, even a dove settled on the cross are besides seen really realistic. Galileo so made a series of profound finds utilizing his new telescope, including that the Moon has craters, vales, and mountains much like the Earth s terrain. He besides was able to see four little visible radiations revolving around the planet Jupiter and discovered that the planet Venus had stages much like our Moon. Later at University of Padua he was exposed to a new theory, proposed by Nicolaus Copernicus, that the Earth and all the other planets revolved around the Sun. Galileo s observations with his new telescope convinced him of the truth of Copernicus s sun-centered or heliocentric theory. Through uninterrupted betterments, the telescope has 30 times more magnification than earlier, enlarged 1000 times to aims. The astronomy research is a landmark revolution. Thousands of old ages uranologists observed the epoch of Moon and stars through bare oculus entirely can stop, it is replaced by optical telescopes, with this powerful innovation, the door to modern uranology was opened. The innovation of the telescope and the series of finds that resulted from it made Galileo celebrated. However, by back uping the theory of Copernicus he aroused resistance in of import Catholic Church circles, and in 1616 he was ordered to halt from learning the Copernican hypothesis. Galileo chafed under this limitation for several old ages. When the Pope died, in 1623, he was succeeded by a adult male who had been an supporter of Galileo. The undermentioned twelvemonth the new Pope, Urban VIII, equivocally stated that the prohibition would no longer be in force. Galileo spent the following six old ages composing his most celebrated work, the Dialogue Refering the Two Chief World Systems. This book was a consummate expounding of the grounds to back up Copernican theory, and the book was published with the permission of the Church censors. Nevertheless, Church governments still responded in choler when the book appeared, and Galileo was shortly brought to test before the Inquisition of Rome on charges of holding violated the 1616 prohibition. It seems clear that many clerics were unhappy with the determination to prosecute the celebrated scientist. Even under the Church jurisprudence of the clip, the instance against Galileo was questionable, and hence he was given a relatively light sentence. He was non arrested in gaol at all, but simply to house apprehension in his ain comfy topographic point in Arcetri. Theoretically, he was to hold no visitants, but that proviso of the sentence was non enforced. His lone other penalty was the demand that he publically abjure his position that the Earth moved around the Sun. This the sixty-nine-year-old scientist did in unfastened tribunal. ( The Religious Affiliation of Astronomer, Scientist Galileo Galilei, 12 July 2005 ) All of this what he has suffered was merely for Copernicans, non for any dissenting theological positions. Furthermore, it may be noted that Galileo s Catholic leaders considered his positions about heliocentricity to be dissident even though himself did non believed to be dissident at that clip. However, today the Catholic Church does non see heliocentricity or any of Galileo s Hagiographas to be dissident anymore. Celebrated Scientists Who Believed in God by Rich Deem stated that Galileo is frequently remembered for his struggle with the Roman Catholic Church. He paid an tremendous monetary value for what he has done throughout his scientific calling. However, after the test and being forbidden to learn the sun-centered system, Galileo did his most utile theoretical accomplishment on kineticss. Galileo expressly said that the Bible can non be incorrect, but he was merely refering the issue of how the Bible should be interpreted. Galileo, it would be noted, was a profoundly spiritual adult male. Despite his test and strong belief, he did non reject either faith or the church, but merely the effort of Church governments to smother probe of scientific affairs. Of greater importance, nevertheless, is the function he played in establishing modern scientific method. I have rather justly admired Galileo as a symbol of rebellion against bigotry, and against autocratic efforts to smother freedom of idea. Galileo is likely more responsible than any other adult male for the empirical attitude of scientific research. It was him who foremost insisted upon the importance of executing experiments. He rejected the impression that scientific inquiries could be decided by trust upon authorization, whether it be the dictums of the Church of the averments of Aristotle. He besides rejected trust on complex deductive strategies that were non based on a steadfast foundation of experiment. Medieval pedants had discussed at great length what and why should things go on, but Galileo insisted upon executing experiments to find what really did go on. In this instance, I am rather inspired by him with his scientific mentality. In decision, Galileo was a really rigorous Catholic but he had some imperfectnesss that was nt in Catholic manner. However, this will no impact him to go one of the greatest scientists in history. There is no uncertainty that Galileo Galilei has been named one of the smartest work forces in history. His innovations and theories have an tremendous impact on modern scientific discipline. It besides has been a great success to our society. With his magnificent work, he will everlastingly be remembered as the innovator of scientific discipline, and for how he brought the universe into a new epoch of cognition. Most of all, he will ever be remembered as the adult male who cared more about working out the truth than himself.
Wednesday, November 6, 2019
Assisted Ventilation in Status Asthmaticus Essays
Assisted Ventilation in Status Asthmaticus Essays Assisted Ventilation in Status Asthmaticus Paper Assisted Ventilation in Status Asthmaticus Paper Assisted Ventilation in Status Asthmaticus Background When a patient is admitted in the Intensive Care Unit (ICU) with a diagnosis of status asthmaticus, it means that the asthma attack is extremely severe and critical.à In this situation, the patient does not respond to high doses of steroids and inhaled bronchodilators.à According to Groth, this resistance to medication is most likely the consequence of three things that make it extremely hard to get air in and lout of the lungs.à These three factors are as follows: à ·Ã à à à à à à à Bronchospasm, which is a condition of an extreme spasm of the airways. à ·Ã à à à à à à à Edema, which is a condition when the lining of the airways is swelling. à ·Ã à à à à à à à Thick mucus secretions in the airways. Normally, when an individual breathe in, the airways are pulled open when the chest wall becomes larger; however, when the individual breathe out, the airways have a tendency to collapse, locking in air in the chest. However, when a person is an asthmatic, emptying the lungs takes a long time for the reason that the airways are restricted. An asthmatic person cannot totally empty the lungs prior to having to take one more breath. When a person is severely asthmatic, he/she experiences shorter breathing so he/she tries to breathe faster and he/she has little time to exhale. When this happens, the lungs keep hold of, or ââ¬Å"trap,â⬠lots of air, which is called hyperinflation or air-trapping. Moreover, this procedure makes it more difficult to take another breath in, and the breathing muscles have to try harder and make more effort to take in any air. Groth said that a young or if not a healthy asthmatic can more often than not surmount this complexity, but at the expense of a c onsiderable strain on the breathing muscles. Then, when this demand is continued for too long, for instance due to resistance to medicine, the asthmatic personââ¬â¢s breathing muscles can get exhausted and he/she will acquire respiratory failure. Furthermore, according to Corbridge and Hall (1995), status asthmaticus is a life threatening type of asthma described as a situation in which an increasingly worsening attack is impassive or not responsive to the customary proper treatment with adrenergic drugs and that causes pulmonary insufficiency. The most important mechanical occurrence in status asthmaticus is a progressive rise in airflow resistance. In addition, mucosal edema or inflammation and mucous plugging are the primary causes for the late recovery in status asthmaticus. Ibsen added that the combination of acidosis, hypercapia, and hypoxia together with the mechanical consequences of increased lung volumes might bring about or cardiovascular arrest or cardiovascular depression. Indications for ICU Admission à à à à à à à à à à à Schwarz and Lubinsky (1997) asserts that a person with status asthmaticus should be admitted to ICU when he/she feels the following: à ·Ã à à à à à à à Exhaustion à ·Ã à à à à à à à Altered sensorium à ·Ã à à à à à à à Presence of high-risk factors à ·Ã à à à à à à à Use of continuous inhaled beta-agonist therapy à ·Ã à à à à à à à Failure to improve in spite of adequate therapy à ·Ã à à à à à à à Increasing PCO2 ins spite of treatment à ·Ã à à à à à à à Markedly decreased air entry Due to difficulty in breathing, a person with status asthmaticus admitted in then ICU is ventilated through assisted or mechanical ventilation. Groth said that a mechanical ventilator takes over the function of breathing in the course of status asthmaticus; however, it does nothing to overturn airway inflammation or bronchospasm. The main function of a mechanical ventilator is to sustain breathing for the exhausted muscles until such a time when a variety of medications become helpful and effective. For a patient in the ICU to obtain mechanical ventilation, he/she needs an endotracheal tube, which is a plastic tube that is inserted by means of the nose or mouth into the windpipe or trachea and is linked to the ventilator. Moreover, the patient must likewise be sedated with an opioid-like morphine called fentanyl and medically paralyzed so as to let the ventilator function effectively and to make the patient comfortable. Mechanical Ventilation à à à à à à à à à à à If the patient has already undergone rapid extubation but still suffers difficulty of breathing, there is probably a failure in extubation.à Werner (2001) says that extubation is a major complication of translaryngeal intubation, but its impact on mortality, duration of mechanical ventilation (MV), length of intensive care unit (ICU) and hospital stay, and need for ongoing hospital care has not been adequately defined. à à à à à à à à à à à Hence, in the case of extubation failure, the patient in the ICU should be intubated. Epstein et al., (2000) said that as many as 20% of extubated patients require reintubation (specifically extubation failure) within 72 hours of extubation, with the exact prevalence depending on numerous factors. The pathophysiologic basis of extubation failure is often different from the cause of weaning failure. Extubation failure substantially prolongs the duration of mechanical ventilation, intensive care unit stay, and hospital stay, and substantially increases hospital mortality. Therefore, prediction of extubation outcome and prevention of extubation failure may be critically important. Unfortunately, standard weaning tests have not proven sufficiently accurate in predicting extubation outcome. New semi-objective measurements of cough strength and secretion volume can help recognize patients at increased danger for extubation failure. It is signifi cant to observe that mortality increases with reintubation delay, which illustrates that clinical worsening might occur during the period without ventilatory support. As a result, better result possibly will come from rapid detection of patients at increased danger, followed by quick reinstitution of ventilatory support when extubation failure happens. Schwarz and Lubinsky (1997) also said that the patient in the ICU should be intubated and mechanically ventilated he/she suffers the following: à ·Ã à à à à à à à Diminishing level of consciousness à ·Ã à à à à à à à Significant hypoxemia that is poorly responsive or unresponsive to supplemental oxygen therapy alone à ·Ã à à à à à à à Apnea or respiratory arrest à ·Ã à à à à à à à Impending respiratory failure marked by significantly rising PCO2à with fatigue, decreased air movement, and altered level of consciousness The choice to intubate an asthmatic should be done with tremendous concern. According to Cox, Barker and Bohn (1991), positive pressure ventilation in an asthmatic person is made difficult by acute air trapping and airway obstruction that causes hyperinflated lungs, which might refuse to accept further inflation and puts the patient at high danger of barotrauma. As a result, mechanical ventilation must be carried out just in the face of constant deterioration regardless of maximal bronchodilatory therapy. Moreover, Werner (2001) agrees that the assessment and choice to intubate an asthmatic should not be taken without due consideration, and intubation must be prevented if possible. Tracheal intubation may aggravate bronchospasm (Oââ¬â¢Rourke Crone, 1982) and positive pressure ventilation will significantly boost the danger of circulatory depression and barotraumas (Williams et al., 1992). According to Corbridge and Hall (1995), ventilator management can be challenging to a certain extent. For this reason, the following principles should be applied in taking care of a patient with status asthmaticus in the ICU: à à à à à à à à à à à 1.Do not attempt to regulate or normalize the pCO2. Tolerate hypercapnia, and make use of pharmacologic buffering agents if needed to raise the pH to 7.2. How high a pCO2 you could do with to endure is determined by the pressures required to ventilate the patient. à à à à à à à à à à à 2.Make an effort to keep plateau (alveolar) pressures 30-35 cm H20. Peak pressures might be higher than this because of increased airways resistance. à à à à à à à à à à à 3.Small tidal volumes are typically required because of propensity and high resistance for air trapping. 5-7 cc/kg is a logical and practical place to begin. à à à à à à à à à à à 4.Rate must be low and expiratory time long, inspiratory time somewhat short. The plan is to leave as much time as possible for expiration, without causing the inspiratory pressure to be extremely high since you are attempting to get the gas in over too short a period. Rates of 10-14 and I:E ratios of 1:4 to 1:6 are usual. à à à à à à à à à à à 5. Pressure cycled or volume cycled ventilation can be employed. If employing volume-cycled ventilation, be certain to look at the pressures generated cautiously. If employing pressure cycled, the ventilator will typically not arrive at ââ¬Å"plateauâ⬠or no flow, and you have to look at the volumes delivered. Regular reassessment is vital. à à à à à à à à à à à 6.If you come across problem with oxygenation or just cannot move the chest, manually bag the patient and re-examine therapy and ventilator strategy. à à à à à à à à à à à 7.Case series and some anecdotes show that there has been certain success with the use of pressure support ventilation in the sedated, but not paralysed, intubated asthmatic. Its regular use has not been subjected to controlled trials. à à à à à à à à à à à 8.The patient should be well sedated and generally paralyzed during mechanical ventilation. Constant infusions or doses scheduled on a regular basis must be used. à à à à à à à à à à à 9.Premedicate with lidocaine and extra sedation prior to suctioning to lessen the bronchoconstriction in reaction to stimulation. à à à à à à à à à à à 10.Go on with insistent bronchodilator therapy-aerosols or MDIs, atrovent, intravenous terbutaline, and steroids. Take into account ââ¬Å"kitchen sinkâ⬠therapies like ketamine, magnesium, isoflurane, and helium. Respiratory Acidosis, Metabolic Acidosis and Permissive Hypercapnea as a Lung Protective Strategy According to (Rebuck and Read, 1971), the customary regulation that respiratory acidosis determines or affects intubation has become outdated. With the start of more insistent utilization of inhaled b-agonist therapy, 1% of asthmatic children confined in the hospital (Cox, Barker and Bohn, 1991) and around 5 to 10% of asthmatic patients confined inà pediatric intensive care (Pirie et al., 1998) need intubation. Rebuck and Read (1971) maintains that asthma is a sickness of airway obstruction, specifically, increased airway resistance, causing persistence of the time constant or the time required for lung units to fill and empty. Hence, slow ventilator rates are typically required. Tuxen and Lane (1987) also claims that during high peak airway pressures, the rule of mechanical ventilation of patients with status asthmaticus is controlled hypoventilation, putting up with higher levels of PCO2à so as to peak inspiratory pressures and reduce tidal volume. The incidence of respiratory acidosis goes after that of hypercarbia (Nowak, 1983). In addition to acute airflow limitation, metabolic acidosis might also happen (McFadden and Lyons, 1968). Numerous instruments are possibly included. Then, according to Roncoroni et al. (1976), if cardiac output is compromised, hypoxia of the peripheral tissues might trigger lactic acidosis to build up or worsen. Furthermore, increased oxygen consumption by the respiratory muscles might be a factor as well. Also, it might likewise be generated with the aggressive administration of nonselective sympathomimetics (Appel et al, 1983). Darioli and Perret (1984) established the idea of controlled hypoventilation with lower-than-traditional respiratory rates and tidal volumes in asthmatic adult patients, and discovered a significantly reduced frequency of barotrauma and death measured up to to historical control subjects. Meanwhile, this idea has been broadly accepted and realized to develop outcomes in asthmatic adult patients. Moreover, this concept, which is called permissive hypercapnia has also been reported in asthmatic children patients. Dworkin and Kattan (1989) dispensed mechanical ventilation to 10 children with the purpose of keeping peak inspiratory pressure , 60 cm H2O and arterial pH . 7.10;à Paco2 ranged from 40 to 90 mm Hg; then, they did not detect air leak following intubation, and all of the 10 children survived. In addition, Cox et al (1991) said that when asthmatic children being given mechanical ventilation with initial tidal volumes of 10 to 12 mL/kg at rates of 8 to 12 breaths/min, inspirat ory time was set at 1 to 1.5 s (considering an expiratory time of approximately 5 s), and tidal volumes were modified to keep peak inspiratory pressures at 45 cm H2O, just two postintubation pneumothoraces were observed, and all children survived without sequelae in spite of considerable hypercarbia throughout mechanical ventilation. Werner (2001) said that permissive hypercapnia could be endured provided that the patient continues to be sufficiently oxygenated. A longer I:E ratio, frequently more than 1:3-4, helps tolerate slow but total emptying of the lungs during exhalation, helping and assisting ventilation and preventing unnecessary further air-trapping (auto-PEEP). The utilization of positive end-expiratory pressure (PEEP) is contentious (Werner, 2001). A person with status asthmaticus in respiratory failure on mechanical ventilation frequently has a considerable amount of air trapping that causes intrinsic PEEP, which possibly will be worsened by means of continuing PEEP during exhalation. Nevertheless, a number of patients may perhaps gain by the addition of PEEP, maybe by way of preserving airway patency during exhalation. Therefore, in a patient in the ICU who continues to be refractory to the initial ventilatory settings with no or very low PEEP, carefully escalating the PEEP may possibly demonstrate to be beneficial. Werner (2001) added that customarily, slow controlled ventilation with heavy sedation and with or without muscle relaxation is the strategy employed to ventilate patients with status asthmaticus. However, warning is necessitated, because the use of muscle relaxants with high-dose steroids has been linked with the growth of prolonged paralysis. On the other hand, a number of practitioners give an account of ventilating children with status asthmaticus with pressure support alone, enabling the patient to set his or her own respiratory rate as identified by his or her own physiologic time stable at the same time helping ventilation by means of relieving the fatigue caused by considerable work of breathing. Noninvasive positive pressure ventilation (NPPV), for instance, continuous positive airway pressure (CPAP) or bimodal positive airway pressure (BiPAP) delivered by way of a facemask, has been utilized for support of status asthmaticus. NPPV has been demonstrated to splint the airways, letting better exhalation and emptying (Werner 2001). Tuxen and Lane (1987) asserted that patients necessitate monitoring and supportive measures during mechanical ventilation. They also said that patients might be uneasy and air hungry while ventilated with low respiratory rates, and hypercapnia as a result of an approach of controlled hypoventilation. Preferably, flow-volume loops should be monitored to determine if sufficient time is given for exhalation to evade breath stacking, which happens if the next breath is delivered prior to exhalation is finished. Moreover, monitoring autoââ¬âpositive end-expiratory pressure (auto-PEEP) and exhaled tidal volume is vital as well. Pirie et al. (1998) said that electrolytes and fluids must be monitored. Prior to arrival in the hospital, children with status asthmaticus have frequently had reduced oral intake and might have been vomiting as a consequence of respiratory difficulty or adversative effects from their medications. This causes decreased intravascular volume status that might be potentiated by the outcomes of positive pressure ventilation. Furthermore, cardiac output might be reduced as a consequence of lessened preload that are caused by auto-PEEP and air trapping. This decreased cardiac output and intravascular volume might perhaps be complemented by metabolic acidosis. Intravascular fluid expansion is necessary to cure hypotension, hypoperfusion, or metabolic acidosis. Moreover, diastolic hypotension might irregularly develop from high doses of beta-agonists. A vasoconstrictor (specifically, phenylephrine or norepinephrine,) might be taken into account if considerable diastolic hypotension in the face of sufficient intravascular volume persists. Monitor serum electrolyte levels, as medications used to treat asthma can result in significant kaliuresis (Tuxen and Lane, 1987). Meanwhile, Nowak et al. (19833) said that placement of indwelling arterial catheters offers nonstop blood pressure monitoring in addition to arterial blood gas sampling. They also maintained that blood gases must be monitored to evaluate response or reaction to therapy in mechanically ventilated patients. à à à à à à à à à à à Meanwhile, mechanical ventilation utilizing unsuitable settings can generate acute inflammatory response in the lund and acute parenchymal lung injury. The related release of cytokines into alveoli and the systemic circulation (Ranieri et al., 1999) might be a factor to multiple organ dysfunction (Slutsky and Tremblay, 1998) and mortality in acute respiratory distress syndrome (ARDS). ââ¬Å"Lung-protectiveâ⬠ventilation strategies try to evade these outcomes by means of restraining peak lung distension and evading end-expiratory collapse, tolerating the hypercapnia that frequently results; such strategies decreased mortality rate in ARDS in two randomized trials (Slutsky and Tremblay, 1998). Hypercapnia is normally considered as an adverse result of limiting alveolar stress, but in a series of studies, Laffey, Engelberts and Kavanagh (2000) have asked whether hypercapnic acidosis per se might be a factor to the advantages of lung-protective ventilation. They demonstrated that in isolated perfused rabbit lungs, respiratory acidosis protected the lung from ischemiaââ¬âreperfusion injury, while respiratory alkalosis potentiated the damage. The protective result of respiratory acidosis was linked with inhibition of xanthine oxidase, and was prohibited by means of buffering the acidosis; specifically, the protection was because of the acidosis instead of hypercapnia. à à à à à à à à à à à Acidosis restrains the cytokine expression and respiratory burst in macrophages (Roncoroni et al., 1976). Then, Laffey, Engelberts and Kavanagh (2000) have talked about other studies recommending cytoprotection by hypercapnic acidosis. Hence, even though it appears that it is impossible that all of the evident advantage of lung protective ventilation is a direct result of hypercapnia, the hypothesis tackled by Laffey, Engelberts and Kavanagh (2000) is a significant and sensible one. If ââ¬Å"lung-protective ventilationâ⬠in ARDS does decrease pulmonary and systemic inflammation, and possibly multiple organ dysfunction, hypercapnic acidosis as such could possibly be somewhat responsible, maybe by downregulating inflammatory cells, and perhaps other mechanisms in addition to inhibition of xanthine oxidase. Therapy and Care in the ICU ICU therapy begins in step-wise fashion and escalates to a ââ¬Å"kitchen sinkâ⬠approach. This is because there is fairly little data which points to one combination of therapies being superior to others, and because an asthmatic deteriorating despite ââ¬Å"usualâ⬠therapy is in significant danger. Standard therapy includes steroids (solumedrol) and beta-agonists (intermittent aerosols, continuous aerosols, or intravenous terbutaline). ââ¬Å"Adjunctiveâ⬠therapy includes anticholinergic agents (Atrovent). Chest physiotherapy and/or IPV (intermittent percussive ventilation) may be helpful and/or necessary for some patients.ââ¬Å"Kitchen sinkâ⬠therapies include magnesium, helium, ketamine, antibiotics, inhalational anesthetics, aerosolized lasix. à à à à à à à à à à à Based on the literature of Groth, the patient in the ICU must be prescribed continuous nebulization of albuterol for the first eighteen hours after the patientââ¬â¢s admission to the Intensive Care Unit and then switch to intermittent albuterol every two hours. Inhaled ipratropium could also be added every 6 hours. Ipratropium is an anticholinergic bronchodilator, and reduces bronchoconstriction through a different means. Then the patient will continue to be treated with a high dose of intravenous corticosteroids. He/she will also be given antibiotics if he/she has a fever, a high white blood cell count, and increased cough and mucus indicating that he/she has an infection. à à à à à à à à à à à Groth also asserted that several of the treatments of last resort employed in status asthmaticus consist of giving general anesthesia with inhalational anesthetics, which are very effective and powerful bronchodilators. Nevertheless, the help of an anesthesiologist will be needed to give this kind of treatment. Intravenous anesthetics like ketamin, can be useful as well. Recommendations Sin Fai Lam, Mow and Chew (1992) said that a more open-minded use of the ICU for patients with severe asthma has formerly been promoted. Procrastination might bring about a respiratory arrest. The result is at all times worse following a respiratory arrest; Lee, Tan and Lim (1997) gave an account of a merely 50% survival from hypoxic brain damage following a respiratory arrest despite good intensive care treatment. It is not advantageous to wait until the patient is almost dilapidated from CO narcosis to take control of the airway. If active airway intervention is unavoidable, it is preferable to come up with this decision early instead of late. This means that it is better to be pro-active instead of procrastinating. Early endotracheal intubation and mechanical ventilation in the patient with life threatening asthma might be practical procedures that can save life and bring about good clinical outcome. Complete signs for intubation are cardiac and respiratory arrest or considerable alteration in mental state. At other instances, the decision made in the face of increasing exhaustion and progressive deterioration. Based on the various literature discussed in this paper, would like to see more patients who need ventilation be intubated electively instead of as a consequence of a cardiorespiratory arrest. Blood gas abnormalities by itself are not a sign to intubate the patient. Several patients with respiratory acidosis and hypercapnia will respond and react to treatment with bronchodilators and do not need mechanical ventilation. More significant is the development in clinical findings and in the arterial blood gases. Furthermore, procrastination in the instigation of mechanical ventilation when it is certainly necessary is connected to the fear of complications. Definitely, contemplation and reflection should at all times be provided to the possible dangers. Intubation in a dyspnoeic, relentless and anxious patient must be carried out by the most knowledgeable and skilled clinician available. A large endotracheal tube must be chosen because it helps suction and lessens airways resistance. Based on the literature, there are advantages of both oral and nasotracheal intubation, and sedative options in the preparation of the patient differ among people. When endotracheal intubation has been performed, the physicianââ¬â¢s priority should be to take control with positive pressure ventilation. This will necessitate the utilization of sufficient sedation and typically paralysis with a muscle relaxant. Paralysis might regularly merely be necessary in the first stages of ventilation, and must be weaned off as soon as possible to lessen the danger of acute myopathy. Ventilation must primarily be in the CMV manner. Ventilatory settings should also be selected to evade extreme lung inflation. This approach will lessen the danger of systemic hypotension or pneumothorax. Lung inflation is lessened by means of permitting a sufficient time for exhalation (TE). Meanwhile, expiratory time may perhaps be prolonged by means of reducing minute ventilation (VE) by either minimizing inspiratory time (TI) or lowering respiratory rate RR or tidal volume (VT). Inspiratory time is lessened through increasing inspiratory flow rate and by means of employing a square flow wave form. Tidal volumes of 8-10 mls/kg with a respiratory rate of 10-14 and inspiratory flow rates of 60 L/min or higher are frequently appropriate (Sin Fai Lam, Mow and Chew, 1992). A suitable peak airway pressure of 50 mm H20 should be aimed for. Furthermore, controlled hypoventilation is a method employed to lessen the danger of hypotension and barotrauma. The goal is to guarantee sufficient oxygenation, stay away from extreme dynamic hyperinflation (DHI) and tolerate a degree of hypoventilation. It is completely tolerable to let the PCO 2to increase so as to evade DHI. One must not try to normalize the PCO2 to the detriment of DHI (Lee, Tan and Lim, 1997). Hypotension might be attributed to too much DHI. A short experiment of apnoea (30-45 seconds) is indicative, as blood pressure rises and venous return increases during the period of apnoea. If this does not occur, other causes of hypotension like fluid depletion, tension pneumothorax, unnecessary sedation or myocardial depression should be taken into account. Lastly, A number of studies have evidently revealed that mechanical ventilation saves lives in life-threatening asthma (Sin Fai Lam, Mow and Chew, 1992). With good ICU management, the period of required ventilation is short, complications can be kept to a minimum, and there is more often than not no problem in weaning the patient off the ventilator. Nevertheless, we should remember that ultimately, the therapy and remedy of acute life-threatening asthma does not merely begin 3 days prior to the attack, but much earlier, as most acute attacks are avoidable with the appropriate use of standard and regular prophylactic medication, the proper education of patients, the avoidance of trigger factors, the appropriate implementation of a co-management plan between the patient and his doctor, the objective measurement of the PEFR, and the accessibility to medical care in times of crisis.# References Appel D, et al. (1983). Lactic acidosis in severe asthma. American Journal of Medicine. Corbridge T, and J. Hall. (1995). The assessment and management of adults with status asthmaticus. American Journal of Respiratory Critical Care Med. Cox R, G. Barker, and D. Bohn. (1991). Efficacy, results, and complications of mechanical ventilation in children with status asthmaticus. Pediatric Pulmonology. Darioli R, and C. Perret. (1984). Mechanical controlled hypoventilation in status asthmaticus. American Review of Respiratory Disorder. Epstein, S. et al. (2000).à Effect of Unplanned Extubation on Outcome of Mechanical Ventilation. American Journal of Respiratory Critical Care Med. Groth, M. Status Asthmaticus.à Retrieved from http://denverpost.healthology.com Laffey J, D. Engelberts, and B. Kavanagh. (2000). Buffering hypercapnic acidosis worsens acute lung injury. American Journal of Respiratory Critical Care Med. Lee K, W. Tan, and T. Lim. (1997). Severe asthma. SMJ. McFadden E. Jr, and H. Lyons. (1968). Arterial-blood gas tension in asthma. N Engl J Med. Nowak R, et al. (1983). Arterial blood gases and pulmonary function testing in acute bronchial asthma: predicting patient outcomes. JAMA. Oââ¬â¢Rourke P. and R. Crone. (1982). Halothane in status asthmaticus. Critical Care Med. Pirie J, et al. (1998). Changes in treatment and outcomes of children receiving care in the ICUs for severe acute asthma. Pediatric Emergency Care. Rebuck A, and J. Read. (1971). Assessment and management of severe asthma. American Journal Medicine. Roncoroni A, et al. (1976). Metabolic acidosis in status asthmaticus. Respiration (Herrlisheim). Ranieri V, et al. (1999). Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome. JAMA. Schwarz A, and P. Lubinsky. (1997). Acute severe asthma. In: Levin DL and Morriss FC, eds. Essentials of Pediatric Intensive Care. 2nd ed. Vol 1. Sin Fai Lam K, B. Mow, and L. Chew. (1992). The profile of ICU admissions for acute severe asthma in a general hospital. SMJ. Slutsky A, and L. Tremblay. (1998). Multiple system organ failure. Is mechanical ventilation a contributing factor? American Journal of Respiratory Critical Care Med. Tuxen D, and S. Lane. (1987). The effects of ventilatory pattern on hyperinflation, airway pressures, and circulation in mechanical ventilation of patients with severe airflow obstruction. American Review of Respiratory Disorder. Werner, H. (2001). Status Asthmaticus in Children : A Review.à CHEST. Williams T. et al. (1992). Risk factors for morbidity in mechanically ventilated patients with acute severe asthma. American Review of Respiratory Disorder.
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