Study Guide for Crossword Puzzle free essay sample

Guide Acids and Bases: 1. Be able to identify both the Bronsted–Lowry acid and base from a given reaction. ~An acid is a proton donor ~A base is a proton acceptor H3PO4 + H20 H3O+ +H2PO4- H3PO4 is an acid so it is a proton donor. It gives its positive atom to the other element 2. Be able to calculate the pH of a solution given [H3O+] Example: What is the pH of a solution with a [H3O+] of 1 x 10-2 M? The pH level should equal the exponent number of 2. Redox Reactions: Be able to identify what is reduced and what is oxidized in a redox reaction. Ex: What is reduced in the following reaction? 2 Bi3+ + 3 Mg 2 Bi + 3 Mg2+. The reduced element in the following is Bi (Bismuth) because that element is broken down without its charge number. Boyle’s Law: Be able to apply Boyle’s Law to solve for either pressure or volume Ex: A sample of helium gas occupies 1245 mL at 705 mmHg. We will write a custom essay sample on Study Guide for Crossword Puzzle or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page For a gas sample at constant temperature, determine the volume of helium at 745 mmHg. P1V1=P2V2 If the pressure goes down, the volume goes up. V2=P1V1/P2 P1=705 mmHg P2=745 mmHg V1= 1245 mL V2= (705)(1245)/745 877725/745=1179 mL=V2 Charles’ Law: Be able to apply Charles’ Law to solve for either volume or temperature (remember to convert to Kelvin) Example: A gas at a temperature of 95 degrees C occupies a volume of 159 mL. Assuming constant pressure, determine the volume at 15 degree C. V1=V2 T1=T2 95Â °C+273=368K= T1 159 mL=V1 15Â °C + 273=288 T2 V2= (368)(159)/288=204 mL Ideal Gas Law: 1. Be able to calculate molar mass given density Example: For a gas at standard temperature and pressure with a density of 2. 75 g/L. determine its molar mass. Standard temperature and pressure occupies a volume of about 22. 4 L. This is known as the standard molar volume of a gas. V=cn (where c is a constant) n is number of molecules 2. Be able to calculate volume or pressure, using PV=nRT P=pressure, V=Volume, n=number of moles of gas, T=Temperature (Kelvin) R=ideal gas constant (0. 0821) for 1 mole of gas at STP, p=1 atm,V=22. 414 L, T= 273. 15K R=PV/nT

The Beach 19th Century Essays

The Beach 19th Century Essays The Beach 19th Century Essay The Beach 19th Century Essay ‘The seaside was never a place of escape – it has always been a place with its own strict codes of behaviour. ’ Do you agree? What is meant by a code of behaviour? This is a question that can be applied to the way we act and present ourselves in every environment and situation that we find ourselves in daily. What may be socially acceptable to one group may well be frowned upon or even vilified by others. Our behaviour within society has almost certainly changed from generation to generation and a good indicator for this has been the perceived behaviour and appearance when on holiday by the seaside. The way the British and European populace has dress for the beach has been dictated by two main factors, our class back ground and generation timelines. When trips to the beach for recreation reasons were first undertaken it was very much only the middle and upper classes within society who could afford to do so. It was therefore the elite members of the populace that set the standards of behaviour and bearing that were to be expected. As we will see later, it was only when the working and lowers classes began to undertake trips to seaside resorts, that these standards were to be compromised. Class has also been a good indicator of the attire that one wears. During the late 19th century all classes of society used the way they presented at the beach to achieve two main aims: to feel special and also to impress their friends and strangers (Place and Leisure p. 133). People would certainly use their class status and therefore dress to impress. Upper and middle classes appeared too overdressed and they could afford to do so. The working or lower classes could afford to be less choosey and often wore their best working or Sunday clothes. It was therefore possible to see many forms of dress on the main promenade and the beach itself. William Porters 1965 guide to Blackpool points out that all walks of life can be seen walking, sitting, reclining and riding ‘in every variety of costume along the sands and parade above’ (Place and Leisure p133). We clearly then have firm evidence that in the later stages of the 19th century that there was an expected form of dress, set by the higher classes within society, that all visitors were expected to conform to. This can be almost compared to as a form of uniform as uniformity was the least xpected. We can clearly see evidence of the formal types of dress codes in the several of the paintings and pictures contained in the resources Illustration Booklet provide for the course. Let’s first of all look at the painting by Edouard Manet (Plate 4. 4. 16 p. 113). The image that he has created perfectly displays the attitude of late 19th beach wear. The females in the painting are almost dressed for a formal occasion. The children are in no way less dressed and give the impression that their attire is more akin to Sunday school than a day of fun at the beach. There is an obvious lack of flesh on display which is in line with the prudish nature of adults during that era. They have in no way compromised what they wear to accommodate the weather conditions. There is no thought of removing clothes to cool down but an obvious use of paroles by both male and females to keep the heat of the sun at bay. If we then move on to the black and white photographs taken by an unknown photographer of the crowds at Margate beach (Plate 4. 4. 23 p. 120) and the picture taken by Rischgitz of the donkeys and crowds on Blackpool beach (Plate 4. . 24 p. 121) we seen no compromise in their clothing in the 30 years beyond Manet painting. There are some signs that there is a degree of cultural divergence in the two pictures, what we assume as the north/south divide today. There is a more middle class feel to the Margate picture, the cut of their clothes is better and the activity, watching a band perform, is more formal than the activities a Blackpool. Both pictur es have also been taken at the height of the industrial revolution, a time when the north of England was filled with â€Å"dark satanic mills† nd the working classes were actively encourage to â€Å"escape the clogs, smoke and grime† (Figure 4. 17 p. 152) of the industrial towns and cities and spend their new found wealth in resorts such as Blackpool. Working class families now had money to spend and the means to travel around the country. During the inter and post Second World War periods there was a clear shift towards a more informal dress code at the beach. The seaside was still a place to dress to impress but there was much more flesh now on show as can be clearly seen by the 3 generations of a working class family (Figure 4. p. 135, Place and Leisure) posing on the beach. There was still a degree of formality with many who took to the beach and as with the grandfather figure in the picture; some habits are hard to break. Why was there this shift in the way we dr essed, especially post war? The social standing of woman in society could very well have a direct influence on this. Women over the age of 30 got the right to vote in 1918 and they went on to received equal voting rights to men in 1928 (Dalal, 2010, p. 95 and p. 98). Roles under taken by women during the war (Drifte, 2011) gave them a degree of liberation and their own voice. We can see clear evidence of the new culture of women’s beach wear in Shanklin on the Isle of Wight in 1926 (Figure 4. 12 p. 141) during the inter war period and the beach models in 1955 (Figure 4. 14 p. 143) post Second World War. The exposed expanses of flesh are in stark contrast to what people had seen before but it is obvious that the women present are merely conforming to the beach dress code of the time. Music has often influenced our view of the seaside. The Beach Boys certainly gave the impression that a fun time could be had and the Who are often associated with blood and violence. How then have two differing styles of music have an influence on our perceived behaviour of what it is like to go to the beach? The Beach boys While we have seen how music creates an idyllic atmosphere, behaviour at the beach cannot just be judged by the way in which we dress and present ourselves. The period during the 1960’s saw seaside resorts not just a place to get away from it all, but as weekend and bank holiday battlegrounds. Influenced by differing musical cultures, Mods and Rockers would descend, mainly into southern seaside resorts, to dispel the idea that holiday destinations were solely for fun and relaxation. Fashion, social standing and drugs were all part of the tribalism mix that â€Å"smeared the traditional postcard scene with violence and blood† (Daily Express, 19th May 1964) on the beaches of Margate and Brighton. The impact of the violent clashes had a deep a far reaching impact on British society. Who wanted to sit enjoying the sun and ice-cream only to be disturbed by rampaging young British men whose main disagreement was whether the Who or Elvis produced the better rock music? Mods and Rockers had no respect for the traditions of the seaside and the government of the time came down hard on the offenders (On this Day 18th May BBC News Website) with many receiving lengthy prison sentences. The question remains how two different factions could be driven to violence over there choice of music and clothes and whether this violent turn of events would be the new standard of behaviour that was to be expected on our visits to the seaside. In conclusion then we can see that the seaside was a place to escape your normal daily routine and an opportunity that was afforded only to middle and upper classes. They abided by a code of conduct that dictated both dress and behaviour. Over the years and with the ability of the lowers class to experience the joy the seaside resorts, this code of conduct has been eroded to the standards that we see today.

Child Labor laws in agriculture in the US Research Paper

Child Labor laws in agriculture in the US - Research Paper Example US laws with respect to child labor in agricultural and nonagricultural field are entirely different. Minimum age for nonhazardous work in nonagricultural field is 14 for children whereas for hazardous work in the same sector, it is 16. On the other hand, at the age of 10 itself, children can start their work in agricultural sector, if they get parental consent. At the age of 14, children can undertake any work in the agricultural sector without parental consent. Authorities have the belief that agricultural sector is comparatively safe and secure for children to start their works. Even the minimum wage laws are different for agricultural sector. â€Å"Many agricultural employers are exempt from federal minimum wage requirements and they are exempt from overtime requirements under federal law†. In other words, agricultural employers can force the workers to do overtime and that also without providing any overtime allowances to them. Children seem to be the major victims in the agricultural field because of such controversial laws. It should be noted that in any other sector, employees may have trade unions whereas in agricultural sector, such unions are not prevailing and therefore the dictatorships of the employers are taking place in this sector.

In Germany Term Paper Example | Topics and Well Written Essays - 1250 words

In Germany - Term Paper Example According to the term paper "In Germany" findings, modern historians like Kocka claim that the development and expansion of fascism was a long and enduring process, with its roots in the nineteenth century. Apparently, fascism was a complex product of numerous political factors; most importantly, the weaknesses inherent in the German political and party system. I think that this knowledge of history can help to prevent future tragedies similar to fascism. Germany has a well-developed system of art trends and experiences. Expressionism is one of the defining features of German art heritage. Despite the lack of agreement on what Expressionism really means, it takes a definite place in the development of German art. Expressionism has a rich history in Germany. Elger writes â€Å"expressionism, however, was by no means limited to fine art, even though its significance and influence in other areas should not be overestimated. The desire to follow an Expressionist style was equally widesp read in literature, drama, stage design, dance, film and architecture† (8). This being said, Expressionism in Germany comes as a complex and omnipresent phenomenon, which crosses the boundaries of fine art and greatly affects all areas of human creative activity. Simultaneously, as Expressionism affected creative activities in Germany, so was Expressionism influenced by the political and social climate in the country. Art and Expressionism, in particular, is both a product and reflection of the social and political climate in Germany.

COMBATING COMPASSION FATIGUE Essay Example | Topics and Well Written Essays - 1250 words - 1

COMBATING COMPASSION FATIGUE - Essay Example If the connection is prolonged, the practitioner develops compassion fatigue. Yoder (2010) describes compassion fatigue as a vice that minimizes the efficiency of the practitioner due to their increased connection with their duties. Moreover, compassion fatigue develops a nature in a practitioner that tends to ignore the requirements of the patient. The practitioner is overburdened with emotional and spiritual connections to a point that they do not feel the need to perform exemplarily in their position. 16% – 85% of health care workers in different fields suffer from compassion fatigue (Yoder, 2010). This describes the extent of the crisis in the industry. This paper will provide signs that depict signs of compassion fatigue. In addition, I will analyze the problems that may be caused and aid that may relieve caregivers. There are numerous signs that may depict compassion fatigue in a caregiver. Firstly, the performance of the practitioner deteriorates significantly. This is because the focus of the caregiver is shifted to address their emotional problems. Additionally, the caregiver does not concentrate on their work. This decreases their effectiveness to perform. Apart from physical signs, caregiver may suffer from psychological effects. For instance, they find it difficult to stop thinking about their patients and job. Walton & Alvarez (2010) is of the assumption that a caregiver should be able to have a life beyond their job description. A failure to achieve this depicts compassion fatigue. In other occasion, the caregiver becomes obsessed with their patients. In a worst case, of compassion fatigue, the caregiver has trouble sleeping. This is caused by memories and over thinking about their job and patients. Another sign is that the caregiver does not have the energy and will to work. In addition, they become less satisfied with their work. This

A Synopsis Of Tb Health And Social Care Essay

A Synopsis Of Tb Health And Social Care Essay Abstract TB or Tuberculosis being a bacterial disease is highly infectious but it has its cures and measures. The disease is a major point of concern in South Africa, especially in the areas of Western Cape. It is so common among them that one out of ten people develop this disease and if not treated in a timely and effective manner the infected person can affect 20 other people or more in a year. According to the World Health Organizations (WHOs) Global TB Report 2009, South Africa ranks fifth among the 22 high-burden tuberculosis (TB) countries. South Africa had almost 460,000 new TB cases in 2007, with a frequency rate of a projected 948 cases per 100,000 population a major raise from 338 cases per 100,000 population in 1998. (Source, (World Health Organization Statistics, 2009). A Synopsis of TB Tuberculosis being a bacterial disease is caused by micro-organism, a bacilli scientifically, Mycobacterium tuberculosis which enters the body by inhaling through the lungs. From where they can spread to other parts of the body through the blood, lymphatic system via airways or by direct transfer to other body organs. It develops in the body in two stages: Tuberculosis infection in which an individual breathes in the TB bacilli and becomes infected but the infection is contained by the immune system. The other stage is when the infected individual develops the disease himself. Out of those people who do become infected, most will never develop the disease unless their immune system is seriously damaged for instance by stress, HIV, cancer, diabetes or malnutrition. The bacteria remains dormant within the body if the patient is BCG injected. BCG immunization at the time of birth provides up to 80% protection against the progression TB infection to take form of a disease. A basic sign of TB is consistent cough of two weeks, so the earlier the patient goes to the clinic to get a check up, the more curable it is. Other severe signs are bleeding in cough, night sweating, weight-loss and short-breathing. TB in South Africa Africa and southern Africa In their 1997 reports on the tuberculosis epidemic and on anti-tuberculosis drug resistance in the world, the WHO paints a bleak picture of the global failure of health service providers to deal with the burden of tuberculosis. In the 216 reporting member countries of the WHO, representing a total population of 5,72 billion, there were an estimated 7,4 million new cases of tuberculosis in 1995. This represents a rate of 130 cases among every 100 000 persons. In Africa the case rate is 216 per 100 000. The 11 countries of the Southern Africa subregion contribute approximately 275 000 cases every year to the total case load in Africa. Almost half of these come from South Africa. In an analysis of tuberculosis trends and the impact of HIV infection on the situation in the subregion, it is estimated that by 2001 the smear positive case rate would have increased from 198 per 100 000 population for the region as a whole, to 681 per 100 000 if tuberculosis control efforts are not optimised. To aggravate the situation, 69% of these cases would be directly attributable to HIV infection.1 A serious complication of the tuberculosis problem in Southern Africa has been the emergence of multi-drug resistant (MDR) strains of the organism causing the disease. Patients infected with MDR require prolonged chemotherapy with very expensive medication which will at best cure only half of them. Such treatments cost at least 100 times as much as the cost of curing an ordinary tuberculosis patient infected with drug-sensitive bacteria. Very few countries can afford this additional burden. In order to determine the magnitude of the MDR problem in Southern Africa, and the implication for National Tuberculosis Programmes (NTPs), surveys are being conducted in various countries as part of the activities of the WHO/IUATLD Global Working Group on Tuberculosis Drug Resistance Surveillance. So far, information is available for four countries in southern Africa: Botswana, Lesotho, South Africa, and Swaziland. Results confirmed that initial resistance to first-line drugs is relatively low in southern Africa compared to some other regions in Africa and Asia where the problem is up to 5 times more common. Resistance rates range between 4% and 12% for isoniazid, and between 4% and 7% for streptomycin. For rifampicin it is 1% and for ethambutol 1%; MDR is fortunately still low at 1%, indicating that resistance strains are not commonly transmitted from person to person. On the other hand, rates for acquired resistance, that is resistance which has arisen in patients previously inadequately treated for tuberculosis, are at least three times higher than in patients not previously exposed to anti-TB medications. The high rates of acquired resistance point to a failure of control programmes to effectively manage case-holding and treatment adherence. TB Treatment The full course treatment time can stretch up to eight months with consistency as a major factor. People who stop treatment develop a multi-drug resistance which makes the disease more complicated. TB can prove fatal if not treated. The treatment is in two phases: The intensive phase consists of taking four different drugs for five days a week, for two to three months. The continuation phase consists of taking two drugs for five days a week for four to five months. Sputum tests are regularly taken every two months for keeping a check on the progress. DOTS The Department of Health in South Africa has implemented the World Health Organizations DOTS (directly observed treatment short course) technique to make sure patients adhere to treatment. DOTS have been implemented in a good number of clinics in the Western Cape. An essential element of the strategy is the support and back-up offered to TB patients for the entire six to eight-month treatment phase, where they are directly observed taking their medication at the clinic. The DOTS strategy is embedded in the following principles. Government Commitment The support of the national and provincial Heads of the Department of Health has significantly helped South Africa to implement the DOTS strategy. This support is essential because DOTS requires significant changes of approach and tends to challenge old practices. Although the strategy offers the least expensive way of tackling TB, often it requires substantial redirection of funds and this cannot happen without the political commitment and support of key decision makers. Directly Observed Treatment Short-course as a global initiative, is a breakthrough that is increasingly providing solutions to the control of the TB epidemic in South Africa. However, it is a new strategy and as such may seem at first complicated and confusing. This merely shows the need to effectively and adequately reorientate our resources and train health staff and treatment supporters to this strategy. This means that each one of us from all sectors has a major role to play. TB is everywhere and as such effective TB control should be practised everywhere. Good TB control is part of good district development. 2.2 Identifying Infectious Patients TB is a bacterial disease and bacterial tools should be used to manage it. The TB Control programme is moving away from chest x-rays as a primary method of diagnosis. A crucial element of DOTS is to use microscopes to ensure that infectious TB is reliably and cost -effectively diagnosed. The first priority and the key issue in the new programme is to cure infectious patients at the very first attempt to slow down the epidemic. The over use of x -rays is discouraged as the primary means to confirm the diagnosis of TB because it does not tell whether a patient is infectious, and it is difficult to distinguish between active TB and other lung diseases or scarring. This leads to over diagnosis so that health workers could be treating many patients that do not have active TB and are not sick with TB. More importantly, the TB epidemic in South Africa is approaching uncontrollable levels and energies should be concentrated on curing infectious TB patients to stop the spread of this disease. Only bacteriology identifies infectious patients. 2.3 Direct Observation of Treatment The implementation of DOTS ensures that every TB patient should have the support of another person to ensure that they swallow their medication daily. The treatment supporter does not have to be a professional health worker, but can be any responsible member of the community. Employers, colleagues and community members can act as treatment supporters. Using family members is often problematic but has been successful in exceptional cases. This person should know the signs and symptoms of TB, side effects of TB drugs and the importance of taking TB medication regularly for the patient. They should also motivate and empower patients and their families and provide them with a better understanding of TB and the importance of cure. Treatment supporters are best recruited as part of a community based system which is reviewed annually and its results documented. Treatment supporters should work closely with local health authorities. Because of the length of time, the patient has to take treatment, completing TB treatment is a special challenge and requires an unyielding sense of commitment. This may be easy to sustain while the patient feels sick. However, after a few weeks of taking treatment, patients often feel better and see no reason for continuing their treatment. It is thus essential for health workers or treatment supporters to be supportive and use the initial period to bond with the patient. This will enable them to build a strong relationship in which the patient believes and trusts advice given by the treatment supporter. 2.4 Standardized Drug Combinations A daily dose of a powerful combination of medications is administered to TB patients for five days a week. Combination tablets simplify treatment and ensure that drugs are not given separately and therefore decrease the risk of drug resistance. 2.5 Reliable Reporting System A reliable recording and reporting system is necessary in order to monitor progress. Sputum results should also be recorded to document smear conversion. This gives an accurate measurement of performance and one can identify areas which need support. The First Step to Filling the Country with DOTS: Setting up Demonstration and Training Districts (DTDs) in 1997 was one of the first crucial steps in the implementation of the DOTS strategy. In South Africa at least one Demonstration and Training area was identified in each province where all the elements of DOTS would be adopted in the management of TB services. Initially these areas would receive the necessary resources and support to ensure that they function well. When these districts demonstrate success in implementing DOTS they can be used as examples and training points to expand DOTS provincially and country-wide. Major Barriers Everyday TB kills nearly 5000 people, which is one person every 20 seconds. (WHO, Global TB Report, 2009). There is a presence of numerous barriers while accessing TB care especially in the poor communities: Economic Barriers Delay in seeking health care occurs due to lack of money for transport plus the time lost working. Socio-cultural Barriers Lack of awareness and stigma about TB. Geographical Barriers Long distances from health care facilities and TB diagnosis and treatment centers. Health System Barriers Delays in diagnosis as a result of knowledge lapse among health care workers. The ever existing barriers to the success of the targets involve overlooking of TB control by government, lack of monetary and human resources to provide regulation and quality control, weak and stigma health systems, poorly managed TB control health centers, poverty in majority of communities, population escalation and a significant boost in drug-resistant TB (particularly MDR-TB) and the recent, extensively drug-resistant TB (XDR-TB). Lack of new diagnostic tools has impeded progress in TB control programs. Perhaps the greatest challenge to achieving the TB targets, however, has been the ever-growing HIV outbreak and the resultant increase in HIV-associated TB. A regional emergency was once declared in the large parts of this region due to unrestrained epidemic of HIV-associated TB.  The start of such an epidemic as the TB/HIV one has seriously compromised even historically firm national TB programs working globally. TB programs are weighed down by this increasing volume of HIV-associated TB cases and by the necessity to manage cases and ensure treatment completion. in addition, TB is the leading source of death among HIV-infected persons, and HIV is the strongest forecast of progression from dormant TB infection to active disease. Thus, TB programs that were almost up to the mark by WHA-set global TB targets have seen their treatment and completion rates plummet. The TB/HIV combination has also had a remarkable impact on human resources.  In a labor force that has remained the same or shrinked, the increased overall number of TB patients has damaged TB programs infrastructure and amplified poor TB results such as treatment default, death and the emergence of XDR-TB. The HIV-associated TB epidemic has led to an escalating rate of smear-negative and extra pulmonary TB;  these forms of TB do not add to the case-detection targets and are more difficult to identify. Moreover, smear-negative TB has a worse prediction than smear-positive TB amongst those who are also HIV-infected. TB and HIV The HIV outbreak has led to a massive increase in the number of fatal TB cases. TB is not accountable for a third of all deaths in HIV infected people. People with HIV are far more vulnerable to TB infection, and are not as much able to fight it off. Recent studies by Wood, (2007) in a region with an approximate HIV prevalence of about 20% in Cape Town, calculated that the pulmonary TB-warning rate among HIV-infected persons in that area amounted to 5,140 cases per 100,000; and that the rate amongst HIV-uninfected individuals in the same area was 953 cases per 100,000. Using these statistics, the determinable fraction for TB among HIV-infected individuals in that area aggregated to 82 percent. Conclusion Recommendations The overall purpose of the project is to identify risk factors and make appropriate recommendations based both on the available evidence and the studies that stem from this project. As such, recommendations are structured in terms of the conceptual framework of this document. Nevertheless, the existing evidence from current data and literature reviews allows us to pinpoint areas where interventions are clearly required. On these grounds, we can make certain recommendations. Introduce epidemiologically-led behavioural interventions Reference has been made to the heterogeneity in HIV prevalence in the province (Shaikh et al, 2006). This unevenness is also apparent in the provincial TB profile. It is therefore important to identify the geographical focal points for interventions according to this disease distribution that has been identified by routine surveillance. Populations at high risk for infection may be identified according to geographical area, as well as according to other demographic factors such as age, sex and socio-economic status. By raising awareness in populations at high risk and targeting specific high risk behaviors, interventions will be more effective in lowering the incidence of new infections. Target hotspots first Once populations at risk have been identified, geographically discrete regions should be selected for resource allocation and focused interventions. An implementation of interventions based on the known and expected burden of disease will prioritise the roll out of a prevention strategy. Prevention efforts that address HIV infection should identify areas and populations where there are certain risk factors and areas of high HIV prevalence must apply concentrated intervention of TB programmes. Identify and manage at-risk groups earlier Behavioural and communication strategies for highest risk groups must be pro-active in their efforts, and target the false sense of security that exists regarding the risk of HIV infection. At-risk populations should include vulnerable groups such as women, and also specific groups such as prisoners, commercial sex workers, mobile persons and labour migrants. Awareness of the risk of TB among HIV infected people must be raised both in communities and within the health service. Integrate prevention and treatment While evaluating the effectiveness of prevention programmes within an epidemiological context, the potential future impact of treatment of both HIV/AIDS and TB needs to be examined. Adapt relevant public services Goal-directed partnerships between social-cluster group departments should be actively pursued. Resource allocation must be rationalised within a broader spectrum than only the health services. The high burden of TB must be taken into account in this process, and be assigned equal importance as the efforts against the spread of HIV. In addition to intersectoral collaboration towards intervention for both these infectious diseases, more effort must be made to integrate the management of HIV/AIDS with TB. .

DISCUSS HOW FAR JOHN PROCTOR, ELIZABETH PROCTOR AND REVEREND HALE CAN :: English Literature

DISCUSS HOW FAR JOHN PROCTOR, ELIZABETH PROCTOR AND REVEREND HALE CAN BE SAID TO REMAIN TRUE TO HIS OR HER BELIEFS The Crucible is a container that resists hear or the hollow at the bottom of an ore furnace. However its connotations include melting pot, in the symbolic sense, and the bearing of a cross. Elizabeth, John Proctor's wife; a cold, childless woman who is an upright character who cannot forgive her husband's adultery until just before he died: she is accused of being a witch. Reverend Hale, a self-proclaimed expert on witchcraft; at the play's end tries to save the accused. John Proctor, a good man with human failures and a hidden secret, a affair with Abigail, he is often the voice of reason in the play; accused of witchcraft. "I do not judge you. The magistrate that sits in your heart judges you." This is where Elizabeth suspects that John has committed adultery, but knows how good of man he is and tries to look over it. "Adultery, John." This is where John tells her and she makes it sound like it is news to her even though she has known for a while. She is trying to have John have a "good" name and not be a name that everyone discards. "No, sir." Here she is protecting his name but she doesn't know that John has just come out and said that he committed lechery. She thought that she was saving him but she was actually making it worse for him. "I mean to crush him utterly if he has shown his face." Here he is talking about if he ever encountered the Devil that he would literally kick his ass. This shows how he is a hipper rite against being a Puritan. Even though he is a religious man he still has the human character of having an evil side to himself. "But I will cut off my hand before I ever reach for you again." John is talking to Abigail and how he is finished with seeing her and that he doesn't want any part of her. John goes through from being amoral to immoral and then to moral, then back to amoral at the end. "It's winter in here yet." Elizabeth and John were talking about how he was working all day seeding even though he was at Salem to see what the fuss was all about. Here he shows his character toward Elizabeth by lying to her and she can't trust him. "Let Rebecca go like a saint, for me it is a fraud." This shows how he changes and starts to take

Sepsis: Blood and Fluid Resuscitation

Sepsis; pathophysiology, etiology and treatment Abstract To define the disease known as sepsis, briefly discuss its pathophysiology, etiology, signs, symptoms, and treatments. Outline protocols for sepsis screening, early directed goal therapy, and to establish the nurse’s role in the process. Sepsis is a complex disease, or response to a disease process that can lead to patient mortality rates up to 60%. Gram negative infectious organisms invade the blood stream, and activate a systemic response.This systemic response exacerbates the problem, leading to disproportionate blood flow, alterations in tissue perfusion, and eventually multiple organ failure. Sepsis screening begins in the ER, signs and symptoms that are indicative of sepsis, or early indications of infection that can eventually lead to sepsis should be identified quickly. Since the majority of these patients are already compromised, it is imperative to have proper screening and initiate early goal directed therapy. Following standard protocols has proven to reduce mortality rates by as much as 25%. Sepsis; pathophysiology, etiology and treatmentSepsis has been defined as a suspected or proven infection that has entered the blood stream, and has the clinical manifestations of what has been termed the systemic inflammatory response (e. g. , fever, tachycardia, hypotension, and elevated white blood cell count termed leukocytosis) (Dellacroce, 2009, p. 17). Sepsis can be a result of any infection in the body that has triggered this systemic inflammatory response. Often times especially in the elderly it might be a result of an untreated urinary tract infection, or some other unknown infection that enters into the blood stream.When the invading organism or antigen enters the bloodstream, it releases endotoxins, a toxic substance usually associated with gram negative bacteria, such as Escherichia coli, Klebsiella pneumoniae, Serratia, Enterobactor, and Pseudomonas. In the patient who is ill already this invasion into the blood stream stimulates the release of too much immunodulators, causing an exaggerated response. Vasodilation is the body’s way of increasing blood flow to the attested area, thereby transporting more white blood cells, such as macrophages, to control the original infection.However, vasodilation, without a proportionate increase in blood volume leads to hypotension, increased capillary permeability which allows fluid to leak out of the blood stream and into the surrounding tissue causing edema. Concurrently, fibrinolysis is impaired leading to a decrease in clot breakdown. This is thought to be the body’s attempt to confine the antigen. However, the formation of fibrin clots leads to micro thrombi, causing hypoperfusion of tissues, tissue necrosis and eventually organ failure (Dellacroce, 2009, p. 17).Consequently severe sepsis is evidenced by sepsis-induced organ dysfunction or tissue hypoxia, hypotension, oliguria, metabolic acidosis, thromboc ytopenia, hypotension being a late sign of sepsis. Septic shock is defined as severe sepsis with hypotension, despite fluid resuscitation. Sepsis and septic shock are the most common form of vasodilatory shock, associated with the systemic response to severe infection. Sepsis and septic shock are very common in critically ill patients, elderly, and is accompanied by a high mortality rate.In many cases as high as 30 percent of patients die within the first month of diagnosis, and 50% of patients die within 6 months (Gerber, 2010, p. 141). The growing incidence has been attributed to enhanced awareness of the diagnosis, increased number of resistant organisms, and growing number of immunocompromised patients, and the increase in the elderly population. The early goal is direct therapy interventions and better treatment methods which have resulted in a decreased mortality rate; however the number of deaths has increased, because of the increased prevalence. Porth, 2011, p. 505) The pat hogenesis of sepsis involves a complex process in which the immune system releases a number of proinflammatory and anti-inflammatory mediators. In doing so, the body reacts by generating a fever, tachycardia, lactic acidosis, and ventilation-perfusion abnormalities occur. Hypotension is caused by arterial and venous dilatations, plus leakage of plasma into the interstitial spaces, abrupt changes in level of consciousness and cognition, are a result of decreased cerebral blood flow.Regardless of the underlying cause of sepsis, fever and increased leukocytosis are present. Elevation in lactic acid levels may not always be immediate, but generally a lactic acid level that is above 3. 2 would trigger the sepsis screening and cause initiation of early goal directed therapy. Our role as the nurse is to recognize the signs of sepsis, and or infection that could lead to it, and make the Doctor aware of any abnormal values or signs. Sepsis screening should be done on any patient that present s to ER with symptoms that would indicate infection, or early sepsis.Sepsis should be ruled out by using the screening protocols, and standard blood work, including two sets of blood cultures, (should be from two separate sites fifteen minutes apart) (Dellacroce, 2009). If the patient has passed the sepsis screening, sepsis protocols for early goal directed therapy should be initiated. The sepsis screening for a patient should take a systematic approach. Does the patient have a suspected infection as evidenced by, white blood cells (WBC) in urine, cerebral spinal flood, or other normally sterile body fluid, cellulitis or other skin infection, new pulmonary infiltrate on chest x-ray consistent with pneumonia?Does the patient have systemic inflammatory response syndrome (sirs) as evidenced by, WBC’s greater than 12,000 or less than 4,000, temperature greater than 38C, heart rate greater than 90 beats per minute, respiratory rate greater than 20 breaths per minute, PaCO2 less th an 32, or on a ventilator? Does this patient have organ system failure as evidence by, respiratory on ventilator, vasopressors, and metabolic serum greater than 3. 2, urine output of less than 0. 5 ml/kg/hr or greater than 0. 5 ml/kg/hr above baseline, or platelets less than 100,000?Does this patient have serious condition that indicates septic shock as evidenced by, receiving vasopressors after fluid resuscitation or lactate greater than 3. 9? (EGDT, 2011) Early goal directed therapy or implementation of sepsis bundle, should be priority, after cultures and all blood work has been completed. Antibiotics should be initiated within 3 hours of admission to emergency room, with initial round of antibiotic started within one hour of diagnosis. Central line access should be established for vasopressors.Arterial line should be established to measure central venous pressure (CVP). Fluid resuscitation to maintain CVP of greater than 8, 12-15 for ventilated patients (Soo Hoo, Muehlberg, Ferr aro, & Jumaoas, 2009). Rapid fluid resuscitation is required with these patients it is recommended they receive up to 3 liters of fluid. Mean arterial pressure (MAP) should be maintained via vasopressors to achieve MAP above 65. One of the more recent advances in treatment of sepsis is the administration of recombinant human activated protein c (rhAPC). rhAPC is a naturally occurring nticoagulant factor that acts by inactivating coagulation factor Va and VIII. RhAPC has direct anticoagulant properties, including inhibiting the production of cytokines (Porth, 2011, p. 506). Sepsis is a complex disease that takes a multi-disciplinary team to detect and treat. It is vital for the patients that diagnosis and early treatment begun immediately. This disease process is accompanied by a high mortality rate, so vigilance on the part of the health care team is a must. Screening and early goal directed therapy protocols are vital tools in the treatment of septic patients.The implementation of these tools has been shown to reduce mortality as much as 25%. The health care professional must pay attention to the signs that may be subtle, such as a slight increase in temperature; this is especially tricky in elderly patients whose baseline core temperature may be hypothermic. Nurses should watch pulse rates from baseline, urine output, any changes in mental status. References Dellacroce, H. (2009, July). Surviving sepsis: The role of the nurse. RN, 16-21. Gerber, K. (2010). Surviving sepsis: a trust-wide approach.A Multi-disciplinary team approach to implementing evidence-based guidelines. British Association of Critical Care Nurses, Nursing in Critical Care 2010, 15, 141-151. Porth, C. M. (2011). Essentials of Pathophysiology (3rd ed. ). Philadephia, PA: Lippincott Williams & Wilkins. Severe Sepsis/Septic Shock Screening Checklist for Early Goal Directed Therapy [Protocol]. (2011). LRMC Soo Hoo, W. F. , Muehlberg, K. , Ferraro, R. , & Jumaoas, M. C. (2009, July 4). Successes and Lessons Learned Implementing the Sepsis Bundle. Journal of Healthcare Quality, 31(9-15).

A Sociological Understanding of Moral Panic

A Sociological Understanding of Moral Panic A moral panic is a widespread fear, most often an irrational one, that someone or something is a threat to the values, safety, and interests of a community or society at large. Typically, a moral panic is perpetuated by the news media, fueled by politicians, and often results in the passage of new laws or policies that target the source of the panic. In this way, moral panic can foster increased social control. Moral panics are often centered around people who are marginalized in society due to their race or ethnicity, class, sexuality, nationality, or religion. As such, a moral panic often draws on known stereotypes and reinforces them. It can also exacerbate the real and perceived differences and divisions between groups of people. Moral panic is well known in the sociology of deviance and crime and is related to the labeling theory of deviance. Stanley Cohens Theory of Moral Panics The phrase moral panic and the development of the sociological concept is credited to the late South African sociologist Stanley Cohen (1942–2013). Cohen introduced the social theory of moral panic in his 1972 book titled Folk Devils and Moral Panics. In the book, Cohen describes how the British public reacted to the rivalry between the mod and rocker youth subcultures of the 1960s and 70s. Through his study of these youth and the media and public reaction to them, Cohen developed a theory of moral panic that outlines five stages of the process. The Five Stages and Key Players of Moral Panics First, something or someone is perceived and defined as a threat to social norms and the interests of the community or society at large. Second, the news media and community members depict the threat in simplistic, symbolic ways that quickly become recognizable to the greater public. Third, widespread public concern is aroused by the way news media portrays the symbolic representation of the threat. Fourth, the authorities and policymakers respond to the threat, be it real or perceived, with new laws or policies. In the final stage, the moral panic and the subsequent actions of those in power lead to social change in the community. Cohen suggested that there are five key sets of actors involved in the process of moral panic. They are the threat that incites the moral panic, which Cohen referred to as folk devils, and the enforcers of rules or laws, like institutional authority figures, police, or armed forces. The news media plays its role by breaking the news about the threat and continuing to report on it, thereby setting the agenda for how it is discussed and attaching visual symbolic images to it. Enter politicians, who respond to the threat and sometimes fan the flames of the panic, and the public, which develops a focused concern about the threat and demands action in response to it. The Beneficiaries of Social Outrage Many sociologists have observed that those in power ultimately benefit from moral panics, since they lead to increased control of the population and the reinforcement of the authority of those in charge. Others have commented that moral panics offer a mutually beneficial relationship between news media and the state. For the media, reporting on threats that become moral panics increases viewership and makes money for news organizations. For the state, the creation of a moral panic can give it cause to enact legislation and laws that would seem illegitimate without the perceived threat at the center of the moral panic. Examples of Moral Panics There have been many moral panics throughout history, some quite notable.  The Salem witch trials, which took place throughout colonial Massachusetts in 1692, are an oft-mentioned example of this phenomenon. Women who were social outcasts faced accusations of witchcraft after local girls were afflicted with unexplained fits. Following the initial arrests, accusations spread to other women in the community who expressed doubt about the claims or who responded to them in ways deemed improper or inappropriate. This particular moral panic served to reinforce and strengthen the social authority of local religious leaders, since witchcraft was perceived to be a threat to Christian values, laws, and order. More recently, some sociologists have framed the War on Drugs of the 1980s and 90s as an outcome of moral panic. News media attention to drug use, particularly use of crack cocaine among the urban black underclass, focused public attention on drug use and its relationship to delinquency and crime. The public concern generated through news reporting on this topic, including a feature in which then-First Lady Nancy Reagan participated in a drug raid, shored up voter support for drug laws that penalized the poor and working classes while ignoring drug use among the middle and upper classes. Many sociologists attribute the policies, laws, and sentencing guidelines connected to the War on Drugs with increased policing of poor urban neighborhoods and incarceration rates of residents of those communities. Additional moral panics include public attention to welfare queens, the notion that poor black women are abusing the social services system while enjoying lives of luxury. In reality, welfare fraud is not very common, and no one racial group is more likely to commit it. There is also moral panic around a so-called gay agenda that threatens the American way of life when members of the LGBTQ community simply want equal rights. Lastly, after the 9/11 terrorist attacks, Islamophobia, surveillance laws, and racial and religious profiling grew from the fear that all Muslims, Arabs, or brown people overall are dangerous because the terrorists who targeted the World Trade Center and the Pentagon had that background. In fact, many acts of domestic terrorism have been committed by non-Muslims. Updated by Nicki Lisa Cole, Ph.D.

Wife of Bath

Wife of Bath The Wife's is the sixth tale (of twenty-four, including two by Chaucer), while Coghill in his modern version places it fourteenth. In both, her tale (from what is known to scholars as Fragment III, containing Group D of the tales) precedes the Friar's and the Summoner's. In Robinson she follows the Cook, while in Coghill she follows the Pardoner. In both cases, her tale is the first of a group of seven (Wife, Friar, Summoner, Clerk, Merchant, Squire, Franklin) known as the "Marriage Group", as all of them deal with the subject of authority (where it lies and how it is exercised) in married life.The Wife is unusual in that her prologue is longer than her tale and is far and away the longest prologue Chaucer gives to any storyteller (only the Pardoner comes remotely near her for length). For most tales the prologue is usually an instructive introduction to the tale; here the tale is more of a sequel to the prologue, which is of more interest to the Wife's hearers and us, the modern rea ders.English: Opening folio of the Hengwrt manuscript D...Like the Pardoner, the Wife tells us much about herself, but her account is almost a full autobiography; it appears, again like the Pardoner's prologue, as a mixture of confession and attempted self-justification.The Wife speaks directly from her experience of marriage, while her tale is presented as a kind of model illustration of her theories. She has married, while young, three wealthy older husbands; her fourth husband, closer in age to herself, resisted all her attempts to dominate him. But her most bitter struggle has been with her fifth husband, though ultimately, she got the better of him. She has been widowed five times but is eager to find a new husband. Having inherited the wealth of her various husbands,

Comparison between canadain remand policies and other developed Essay

Comparison between canadain remand policies and other developed countries remand policies - Essay Example This paper is going to discuss the comparison between Canadian remand policies and other developed countries. Trebilcock defined the state of being in remand as a process when an individual is held in custody as they await for their sentensing or trials. Different countries have their policies of handling individuals who break the laws depending on what is considered right or wrong in the particular countries. The reasons for remand in Canada are,ensuring that the accused people do not flee the country,protecting the citizens of the likelihood of criminals reoffending and maintaing the confidence in justice adminstration (Trebilcock,30-34). There are similarities and differences in the remand policies in Canada and other developed countries. In majority of the countries like United States,Canada,Australia among others criminals who are in remand are normally held in court cells,police cells,prisons or psychiatric facilities depending with their levels of crime. The prisoners who have already been sentenced are kept in separate units from those still on remand. Trebilcock stated that the time spent on remand for prisoners in various countries is normally taken off an individual’s total sentensing time. The prisoners are normally assessed carefully by the Courts and given specific offender plans that identify various areas that the individuals can benefit during their prison time where they can learn important skills like managing money,fundamental living skills and parenting skills. The remand prisoners in Canada and other developed countries are helped with their addiction problems and finding ways of employing themselves and getting employed in various organizations. The prisoners in remand in all the countries are similar because they are helped in finding community support and finding accomodation when they return to the society. The prisoners who are considered

Criminal Law U5IP Research Paper Example | Topics and Well Written Essays - 250 words

Criminal Law U5IP - Research Paper Example in interstate commerce through a pattern of racketeering activity; 3) participating in the conduct of a business engaged in interstate commerce through a pattern of racketeering activity, and 4) conspiring to violate any of the above (section 1962). In order for a RICO claim to succeed the plaintiff must show that the conduct of the enterprise or business is through a pattern of activity connected to racketeering. Prior to the enactment of the RICO Act it was difficult to combat racketeering activities (Batista 2007). It was only possible to convict lower ranking members in the rackets as they were directly involved in illegal activities. This meant that racketeering activities still affected businesses and the economy as the higher ranking members were harder to prosecute since they were not directly connected with the illegal activities. The RICO Act provides prosecutors with a tool to fight organized crime (McNeill 2009). The RICO Act is remarkably effective in combating organized crime as it does not require proving that the suspect committed an illegal act but rather that the individual owns or manages an enterprise that regularly conducts an illegal activity prohibited by the Act (Batista 2005). The RICO Act is given a ve ry wide interpretation, and as such legal issues will always arise out of its interpretation and application. The RICO criminal defense practice will, therefore, remain relevant as long as the Act is in use. Racketeer Influenced and Corrupt Organizations Act (RICO), Title IX of the Organized Crime Control Act of 1970, Pub. L. No. 91-452, 84 Stat. 941 (Oct. 15, 1970), codified at 18 U.S.C. Ch. 96,