Consequences Of Passive Listening English Language Essay

Consequences Of Passive earreach English Language EssayPassive seeing occurs when a soulfulness is full aware of a lecture, Conversation, or something audio that is spillage on in his or her presence that the person does not react to it. This essay is going to attempt to explain in expatiate the consequences of passive listening.A passive listener does not interrupt the speaker or perform any action mechanism whatsoever at the same time in which the speaker is delivering his or her speech. In most cases, a passive listener does not nod his or her head, cast appropriate facial expressions, and make eye contacts with the speaker or any other action that indicates whether a person is paying attention or not. When a person concentrates on making non-verbal cues (nodding, eye contacts and so on), then he or she is probably not paying a great deal attention in other words, listening passively because those actions come naturally to a person who is actively listening i.e. he or she does not have to concentrate on doing them. In some cases, passive listening is associated with students in the class room. A student who is listening passively to a lecture barely pays attention to details but at the end of the lecture, the student tends to remember 10% or less of the information passed through during the lecture session. This is because although the student was not paying practically attention to the details, the student will zone in and divulge of his or her mind at regular intervals and in the process accidentally take in some valuable information. Usually, passive listening in students is caused by a dull lecture or an interruption in which a student is attracted to for example, prison cell phones. It is not always the fault of the lecturer because some topics are uninteresting by nature.Despite all the reasons and excuses a student aptitude have for his or her lack of interest during lectures, the consequences for this action will have to be put into cons ideration because it notify adversely affect a persons academic participation and offspring. Listening passively without checking in on a conversation to verify that you have a message correct often leads to communication error. By simply macrocosm in a conversation without interjecting questions or active statements that uncover the speakers real message, a persons personal ideas might begin to form about what the message might mean instead of what the message actually means. An example is when an apprentice technician joins the audience in an inaugural lecture. If he listens passively, he will only manage to listen to the sounds, he will not be able to meaningfully identify the spoken signals not to talk of correctly interpreting what is being said. This will result in errors in the persons solutions or answers. If a person is listening passively, then the person is not speaking. Effective communication allows both the message sender and the manslayer to express themselves in an even exchange of ideas.A passive listener screwing be compared to a rock, you can see it and you know it is there, but it does not seem to be absorbing anything that you are saying. The reason why passive listening is mostly associated with students is because it occurs mainly with teenagers. Passive listening requires a lot of focalization because a passive listener severely focuses on what he or she is listening to but is not doing anything apart from listening meaning he or she is not absorbing any information. The strain on unmonitored focus affects a persons ability to understand. A person can store information correctly in the brain only when both the mind and brain of the individual are relaxed. Straining the brain to listen without any interest on details thus results in a persons lack of understanding, wastage of time and possibly head ache or brain clogging.Some other practitioners of passive listening techniques are those attempting to mark a foreign language the a udio way that is through an mp3 player or an audio CD player. This is common because when advertising these products, the marketing team make promises of satisfying results to whoever uses them. They include attractive slogans like learn French the easy way just by listening to this audio CD while polish your chores. If a person is performing a task while listening to something, then the person is listening passively. The shocking truth is that passive listening cannot have a person to fluency in a language because it ever rarely produces any good results. What is even worse is that it will not table service the ability of the person to understand the language he or she is attempting to learn. It is a fact that a passive listener is unable to correctly store, interpret and ring information, this fact also applies to a language learner who is listening passively. In plain words, a language learner who is listening passively will not be able to store, interpret and recall what has been said because language learning needs some amount of focus and understanding.In some cases, a person does not deliberately listen passively to a lecture or speech, passive listening can occur due to absent mindedness. In this situation, the showtime of this action is either the speaker or the listener. The speaker can be the cause of passive listening in an individual if his or her voice brashness is too low and the listeners will have to strain their ears to listen. There will come a point in time when the listeners will finally base up on listening to the lecture because they are tired of straining their ears and the rest of the valuable information the speaker has to deliver will pass by the listeners ears and go to waste. There is also the case of complexity. When the speaker is using too many complex words or unnecessary issues and details, the listener tends to zone out and start to imagine all sorts of consequences for the discussion at hand and in the process comman ding out on some of the important key points. The listeners can also be at fault because at times, they focus on passing judgment on the speaker, topic or lecture so much that they forget the currently important speech they are supposed to be actively listening to and as a result they listen passively and miss out on the most important parts of the lecture.In my research I have learnt that the word consequence means outcome. The outcome of an event can be both good and bad since everything that has an advantage has a disadvantage. Everything I have mentioned on passive listening so far has been negative but it also has its own advantages.

Episiotomy Rates Vary Widely Worldwide

Episiotomy Rates Vary Widely WorldwideLabour is a wondrous act of nature and unique to all childbearing women. It is a transformative and special event in a womens life. It is the magic of creation. The very process of giving birth is the most beautiful one on earth and the mother attains unique capacities and true nobility by dint of childbirth. The onset of motherhood present a unique set of physical, emotional and psychological challenges.Episiotomy is a common working(a) performance performed during second constitute of labour. The first performance of episiotomy was done in 1742, when perineal incision was do to facilitate difficult deliveries (Grass, Dunn and stys 1986). It is made both to prevent tearing of the perineum and to release pressure on the fetal head with birth (Lawsan and Bienstock, 2007). It is the only procedure in obstetrics is performed without the patients specific consent. The return of an episiotomy is that it substitutes a clean cut for a ragged tear , minimize pressure on the fetal head, and may shorten the last portion of the second stage of labour (Incerpi,2007).Episiotomy rates vary widely worldwide, depending on whether the procedure is used restricvely / flakely. The worldwide episiotomy rate was 27%, 54% argon nulliparous and 6% are biparous women (WHO 2003).Rates vary from 8% in the Netherlands,13% in England to 25% in the USA. Among English speaking countries, the US had the highest episiotomy rate, varying greatly from region to region. peerless in triplet mothers who delivered vaginally in the U.S from 1995 to 2003 had episiotomies.In India the birth rate is very high 56% of women had an episiotomy compared to the 46% of white women. The difference between these percentage (10%) is measure of the excess frequency of episiotomy in Indian women.According to the American college of Obstetrics and Gyenaecology, approximately one in three women having a vaginal lurch in addition turn over an episiotomy. rough 70% of women with a vaginal birth experienced some degree of damage to the perineum due to tear (or) episiotomy and needed stitches. Like any other surgical incision, episiotomy military issues in some discomforts for most of postpartum patients (Hill,2000). Although relatively small in size, episiotomy sutures can cause considerable discomfort, because the perineum is an extremely tender area and the muscles of the perineum are convoluted in so many activities such as sitting, squatting ,bending ,urinating and defecating. Even without episiotomy women may experience bruising / tearing in the perineum. This is the most common witnesser of transmitting in the days after giving birth.Various interventions are found to reduce episiotomy contuse infection and enhance the improve process which let in administration of antibiotics, cleanliness, topical application of ointments, infra red therapy, sitz tub, performance of kegals exercise and perineal care (Helen et.al 2009). In addition co mplementary therapy is another great encourage to perineal healing.In recent years it has been seen that there has been a shift people from allopathy medicine to complementary medicine. The shift may be because people are becoming more conscious of their health and realize the need of holistic health. Quality of life is felt more important. In 2007 National health consultation survey of complementary medicine use by Americans, showed that approximately 38% adults use complementary medicine. A survey by NPS medicine wise in 2008 revea take that 65% of Australians had used one (or) more complementary medicine in the previous 12 months.The term complementary medicine is primarily used to get practices employed in conjunction with (or) to complement conventional medical treatment. Complementary medicine is sometimes called mind body medicine because it is an approach to healing that uses the source of thought and emotions positively influence physical health ( USA Drug, 2005). Com plementary therapies can help to boost the immune system, help eliminate toxins, help hold open pain, improve sleep pattern, increase energy levels, induce sleep relaxation, reduce stress and tension, restore correspondence to body systems. lavender fossil vegetable oil is one of the complementary medicine. It has a light fresh aroma, is clear in color and watery in viscosity. Lavender has been use continuously for thousands of years, either in the form with chromatic water of essential oil / dried flowers. In the 1800s the yardly company in England, realizing the healing properties of lavender , began adding it to their soaps and perfumes. Lavender oil promotes rapid healing and helps to prevent scarring. These remarkable healing properties of lavender were accidently discovered by French chemist Dr. Rene Maurice Gattefosse when he burnt his hand in a laboratory experiment. He instantly plunged it into a nearby bowl of lavender oil and discovered that it stopped throbbing pai n and allowed the burn to heal quickly.The therapeutic properties of lavender oil are antiseptic, analgesic,anticonvulsant,antidepressant,antirheumatic,antispasmodic,antiinflammatory,antiviral,bactericidal,sedative,carminative,soothing,hypotensive,decongestant and diuretic. The master(prenominal) effects of lavender are calming, soothing, balancing and publicizing. Lavender can be used to a state of mental and physical imbalances to a state balance in which healing can take place. On the skin, lavender oil tones, revitalizes and it is useful for all types of skin problems such as abscesses, acne, oily skin, boils, burns, sunburns, appal, psoriasis, insect bites, injuries and also acts as an insect repellant. Lavender oil can be used in a sitz bath and it would also have the added benefit of decreasing care in the new mother which povidine iodine does not.Research carried out at Huntingtons Hinchinbrooke Hospital has found that the use of lavender oil in the sitz bath led to grea ter comfort and improved healing of the perineum between the third and fifth days after delivery.Adding lavender oil to a sitz bath aids in the healing of torn vaginal tissue. It also prevents the formation of excessive scar tissue, according to Margaret Fawcett of Aroma therapist and author of Aromatherapy for pregnancy and childbirth. It is one of the safest essential oil and can be used in full strength on the skin also referred to as neat.The use of lavender oil can be effective in reducing perineal discomfort and promote scandalise healing following episiotomy. It is being used due to its antiseptic and healing properties. Lavender oil is found as a good choice in treating episiotomy wound healing because of its cell regenerating properties.Need for the StudyThe postnatal stoppage refers to 6 weeks period after childbirth. The period is popularly termed the fourth trimester of pregnancy. It comprises an amazing variety of complex physiologic and psychological adaptations. Pr otecting a womens health as these changes occur is important for preserving the future childbearing function and for ensuring that she is physically well enough to incorporate her new child into her family.The physical care a women receives during the postnatal period can influence her health for the rest of her life. The nurses role is vital as she assists the mothers through these adjustments and supports them as they make a fresh fail as a new family. Postnatal women are more prone for puerperal infection as a result of episiotomy which can be prevented by proper postnatal care.Approximately 33% of women with vaginal delivery had episiotomy in 2000 (American College of Obstetricians Gynaecologist, 2008). However the prevalence of episiotomy is not the same in different countries, Asian run are presumed to have smaller and tighter perineum so, the routine episiotomy may reduce the risk of Perineal tearing during delivery (lam et.al 2008).Studies about the episiotomy rates aroun d the world showed that this surgery ranged from 9.7% (western Europe-Sweden) to 96.2% (South Africa-Ecuador) with lowest episiotomy rates in English speaking countries (North America Canada united states) and it remained high in many countries (centered south -America like brazil-94.2%, south Africa-63.3% and Asia like China-82%).One strike revealed that episiotomy was performed in 97.3% of 510 primiparous women who had vaginal delivery in Tehran (Shojariet.al.2009).Barnabas (July 2012) conducted a scan to determine the rate and risk factors for episiotomy at Baptist medical centre, Nigeria. proscribed of 280 subjects who had vaginal delivery, 96 (34.3%) subjects had episiotomy .The rate of episiotomy decreased with parity. The nulliparous had the highest rate (62.2%). The episiotomy rate among assisted vaginal delivery was 80.0% among those who had spontaneous delivery.Law kw, wong Hs, Pan Tc (2006) were reviewed the use of episiotomy during vaginal delivery in Hongkong pupli c hospitals. A prospective observational survey was carried out in total 6222. Women who underwent normal vaginal delivery of a singleton fetus with cephalic presentation of the 6167 women in whom the status of the perineum was known. Episiotomy was performed in 5274 (85.5%). Primiparous women were more likely to undergo episiotomy at delivery than multiparous women (97.9% vs. 71.4%).Several studies suggest that using episiotomy in normal delivery results in fewer perineal laceration and trauma. The episiotomy discomfort and its consequences can affect maternal fictitious character of life as well as the mothers and violate relationship. Like any other surgical procedure episiotomy carries number of risks excessive blood loss, hematoma formation and infection ( Roberts and Chalmers 1989)S.T Sule and S.D. Shittu ( July 2003) conducted a prospective cohort sketch to establish the epidemiological variables associated with episiotomies and their puerperal crookednesss at Ahmadu bedl o university teaching hospital Zaria. The result findings suggest that the episiotomy rate was 35.6% of all vaginal deliveries . Episiotomies were portentously associated with primi gravida. The most common puerperal complications of episiotomies was asymmetry (32.9%), infection (23.7%), partial dehiscence (14.5%), hemorrhage (5.3%) and extension of the incision (1.3%).Nahid Arianpour 2009 (June) conducted a descriptive study to determine the bacterial species in postpartum infections at khanevadeh hospital. postnatal infections among 6077 patients from 2003 till 2008 was studied in this study. In this study out of there different kinds of postpartum infections (i,e genital, breast and urinary tract ). Only genital infection is considered. Postpartum infections among 6077 patients from 2003 till 2008 was studied in this study. In result findings revealed that 7.59% (461 ) patients had postpartum infection, out of which 1.03%(63) patients were re hospitalized. The commonest infecti on was infection at the site of episiotomy.Kathelin Karla (2005) stated that the routine use of episiotomy harmful to the pelvic floor that creates greater extent of surgical incision and delayed perineal wound healing, compared with no episiotomy group.Continues improvement in quality of care after episiotomy could helps to control the infection and improves episiotomy wound healing. Nurse midwife plays on important role to promote postnatal care , to prevent complication of episiotomy wound earlier and hence force to bring a healthy mother. A well integrated postnatal care has an important role in mensurateing the transition to physical and psychological well being of the mother and baby . Episiotomy wound care is important for comfort and cleanliness and to prevent infection.Attention should be afforded to episiotomy wound care since it parallels any other wound. One of the suggested method is a regular antiseptic sitz bath. Nowadays using complementary therapies such as essenti al oils have been recognized in Obstetrics. Mechanism of action of each essential oils is related to its complex active substances .One of the main action of these oils are easy absorption through the skin. The molecule of essential oils are small enough to permeate through the skin barrier. The molecule will be absorbed easily into the skin deep down 20-40 minutes depending on the chemical nature of the oil.Lavender oil is one of the frequently prescribed essential oil due to its antibacterial, antifungal, sedative, anti depressant and healing properties.Research has been done to evaluate the effect of lavender oil sitz bath on episiotomy wound healing (Katayan Vakilan 2012). This randomized control trial was conducted on cxx primiparous women with singleton pregnancy who had received mediolateral episiotomy during spontaneous delivery. Redness in lavender oil group was significantly less than control group (pFatemeh Sheikhan (Feb 2012) conducted a study on use of lavender oil es sence in primiparous women in Iran. This clinical trial was involved 60 primiparous women. In result the REEDA score was significantly lower in experimental group (lavender group) 3 days after episiotomy (p=0.000). It is suggested that lavender oil essence may be quite to the use of betadine for episiotomy wound care.Though there are many studies done in various methods of episiotomy healing, only a very few studies are conducted to assess the effectiveness of lavender oil sitz bath on episiotomy wound healing. So the researcher felt the need to evaluate the effectiveness of lavender oil sitz bath on episiotomy wound healing among postnatal mothers with episiotomy.Statement of the ProblemA study to evaluate the effectiveness of lavender oil sitz bath on episiotomy wound healing among post natal mothers in government head quarters hospital at kanchipuram.ObjectivesTo assess the level of episiotomy wound healing among postnatal mothers in experimental and control group.To evaluate th e effectiveness of lavender oil sitz bath on episiotomy wound healing among postnatal mothers in experimental group.To determine the connective between the level of episiotomy wound healing among postnatal mothers with their selected demographic and obstetric variables in experimental and control group.HypothesisH1-There will be a significant difference between the mean post test level of episiotomy wound healing between experimental and control group.H2- There will be a significant association between the level of episiotomy wound healing with their selected demographic variables among postnatal mothers in experimental and control group.Operational DefinitionEffectivenessIn this study effectiveness refers to the extend to which the lavender oil has produced desirable effect on episiotomy wound healing.Lavender Oil Sitz BathIt is a clean procedure in which the perineal area is immersed in 4 liter of warm water with a temperature of 100 105F added with 5 drops of lavender oil for 1 0-15 minutes thrice a day for 3 days is used.EpisiotomyIt refers to the surgical incision on the median or right/ left medio lateral perspective of the perineum during second stage of labour to enlarge the vaginal introitus, to facilitate easy and safe delivery.Postnatal MothersIt refers to mothers who have undergone normal vaginal delivery and instrumental delivery with episiotomy.Episiotomy Wound HealingIt refers to absence of redness ,edema, ecchymosis , discharge and presence of well approximation of wound as measured by using REEDA scale.Assumption charge of episiotomy wound may predispose to wound infection.Lavender oil aids in improving the healing of episiotomy wound.DelimitationThe study is limited to the postnatal mothers who had normal vaginal and instrumental delivery with episiotomy.The data collection period is limited for six weeks.Projected OutcomesThis study will help in assessment of episiotomy wound healing among postnatal mothers.This study will help to evaluate the effectiveness of lavender oil sitz bath on episiotomy wound healing among postnatal mothers.This study enables nurses to practice lavender oil sitz bath during postnatal period.

Treatment of Paediatric Acute Pain

Treatment of Paediatric Acute PainThe attempt of this evidence is to reckon how the UK NHS paramedics process acute pang in paediatric population. This essay will accentuate the importance of adequate training and research in paediatric care.Paramedics busy by UK NHS Ambulance trust have a diverse selection of analgesics at their disposal for acute mild to severe pain, ranging from paracetamol and ibuprofen to Entonox and intravenous morphine sulphate. (JRCALC) This essay will look at the management of acute moderate to severe pain with emphasis on the barriers that pr blusht paramedics from assessing and treating paediatric patients with pain adequately, as intimately as intravenous morphine versus intranasal fentanyl debate.Different ways of treating pain in tinge services and departments around the public will be discussed and appropriate literature from emergency care will be usaged to support the statements made throughout this essay.Hennes, Kim, Ronald and Pirrallo ( 2005) describe pain as a complex multidimensional phenomenon that is intemperate to assess, particularly in young children. Combined with the fact that pain is the most common symptom in the emergency setting (Alonso and Wensley, 2003), it is fundamental that we understand and remediate the care for all patients in pain.However, there is disparity between assessment and treatment of great(p)s and paediatrics. This phenomenon has been described for over 25 years (Schechter, 1989). Watkins (2006) is in agreement with Schechter (1989) that adult patients are more than twice as likely to receive opiate analgesia for acute moderate to severe pain, when compared with children who describe similar pain scores.The UK NHS Ambulance trust has been under prospicient term criticism, because of wanting(predicate) provision of analgesia for paediatric patients. This view has changed in 2003 when Medicines and Health care products Regulatory Agency approve the use of morphine in the said(pre nominal) group of patients. Today, intravenous morphine sulphate and morphine sulphate oral solution can be safely administer by registered paramedics. Recently, many studies who targeted the emergency services around the world discovered that healthcare professionals are often unable to assess and treat paediatric patient in pain (JRCALC, 2013). consequential step in addressing oligoanalgesia is by identifying the barriers to inadequate pain management. This statement is supported by numerous authors including Ricard-Hibon, Chollet, Saada, Loridant and Marty (1999), Bruns, Dieckmann, Shagoury, Dingerson and Swatzell (1992) and Jones and Machen (2003). Sequelae of inadequate treatment of acute pain may make it to alteration in immune function, delayed wound healing and a lower pain threshold in subsequent painful experiences.Firstly, a qualitative chew over by Murphy, Barett, Cronin, McCoy, Larkin, Brenner, Wakai and OSullivan (2013) explores what barriers prevent adequate treatme nt of paediatric population by emergency service. The study focuses on acute pain in children from the survey of advanced paramedics in Ireland.Authors of the study believe that there are many factors, or barriers as they call it that render the potential pre-infirmary treatment of children inadequate and ineffective. One of the biggest causes identified was the lack of training targeted specifically to paediatric care, current clinical practice guidelines for paediatric pain management, limited exposure to paediatric patients in pre-hospital setting and many others.A huge part of the concern that has arisen from interviews was the difficulty and even inability to assess pain intensity in young children, in particular in preverbal age. Also, a disturbing reason listed for oligoanalgesia was short hospital transfer time, which further added to all possible situations, when practitioners would be reluctant to administer analgesia when dealing with children.Melzack and contend (2003 ), Williamson and Williamson (1983) and Gilianu, Krane, Galloway And Yaster (2000) are all in agreement that exposure to severe pain in children can cause adverse psychological, biochemical, metabolic and behavioural changes.The study cogitate that emergency services must emphasise improvement in paramedic education and training, specifically giving resources to assessing pain in preverbal children. Some advanced paramedics even suggest that treatment of acute pain in paediatrics should be approached differently to acute pain in adults.Through focused group interviews moderated by apaediatric emergency medicine specialist, the authors were able to collect the necessary data. Though the study was easily designed, it had limitations. There were only twelve participants, however, as the authors point out, it has been argued by Howard and Moore (1989) and Kitzinger (1995) that aminimum of octet participants is accepted to be suitable.Another factor that have been identified by adva nced paramedics in the aforementioned(prenominal) study and a study by Hennes, Kim and Pirrallo (2005) from the perspective of paramedics in United States highlights the inability to effectively administer medications available to paramedics.A concern was raised in the area of cannulating a paediatric patient as well using medications that needed to be inhaled, such as Entonox. Both studies found that practitioners were in many cases unable to firstly, assess the pain score, and secondly treat the paediatric patient, due to the fact that children showed anxiety when trying to give intravenous morphine or oramorph.Murphy, Barett, Cronin, McCoy, Larkin, Brenner, Wakai and OSullivan (2013) strongly suggest that identification and mitigation of aforementioned barriers to the prehospital management and treatment of paediatric patients is crucial and should be one of the priorities in further development.Secondly, astudy by Watkins (2006) looked at whether the age of child influenced the likelihood of their receiving prehospital analgesia from their local ambulance services. The study investigated this question in Auckland.Jones, Johnson and McNinch (1996) again raised a concern about inadequate analgesia in paediatric population, which has been further highlighter by Watkins (2006). The study found that children less(prenominal) than 5 years of age are in significant risk of being undertreated of pain by ambulance service.When compared with children who were 5-15 years of age, Watkins (2006) also observed that there was a significant change as they received some form of analgesia in 50% of cases.The study also points out an interesting fact about the use of pre-hospital Entonox. Children given Entonox alone appeared to be in more pain than non-treated children, which is surprising as in adult population, it is account to produce adequate analgesia for 50% of patients. (Ricard-Hibon, Chollet, Saada, Loridant and Marty, 1999).I am sure the air in heaven must be thi s wonder-working gas of delight (Fullmer, 2000)Watkins (2006) suggested several possible reasons for this perception of the effect of Entonox, such as incorrect use leading to inadequate effect, as children are in many scenarios crying preventing them from using the equipment properly. Also, it might be relevant to mention that children achieving sufficient level of analgesia using Entonox were 8 years of age or older. As indicated by Watkins (2006), further research is necessary to establish whether the use of Entonox is suitable for analgesia in children.The study also found that no child aged less than 5 years of age received analgesia in form of morphine, which disagrees with claims made by ambulance officers who participated in the study. Again, the author further confirms the theorem that even qualified practitioners have difficulties in assessing and administering analgesia to young children.As mentioned above, the pain caused by gaining intravascular access leads to underuse of opiate analgesia in younger children. As highlighted by Braude and Richards (2004), further investigation of non-invasive methods of pain relief in pre-hospital setting is absolutely crucial.This leads to a morphine sulphate and intranasal fentanyl debate, which has been the subject of several studies.In hospital setting, intravenous fentanyl was shown as an effective alternative to morphine sulphate, however during the last decade, a new option became available.Braude and Richards (2004) indicate that there are at least(prenominal) four reasons to use intranasal fentanyl in pre-hospital setting. This claim is supported by numerous publications including Watkins (2006), Maurice, ODonnell and Beattie (2002), and Rickard, OMeara, McGrail, Garner, McLean and Lievre (2007).Maurice, et. al (2007) identified that management of acute pain in paediatrics relies on successful intravenous cannulation that may be technically impossible to perform. Moreover, the author also acknowledged th at this increases the risk of needle flag injuries to either the patient or patients family and to the staff.A possible replacement in the form of intranasal fentanyl has been long discussed by many authors. Braude and Richards (2004) have reported that intranasal fentanyl has a rapid peak, short duration of action and does not cause the release of histamine, which may cause hypotension. Also, there are very few instances of sickness being caused by administering intranasal fentanyl.Rickard, OMeara, McGrail, Garner, McLean and Le Lievre (2007) conducted a randomised controlled trial to compare intravenous morphine and intranasal fentanyl for pre-hospital analgesia.Intranasal fentanyl has been used in the inpatient hospital setting, scarcely prior to this randomised controlled trial, there has been no other trial comparing the aforementioned drugs in pre-hospital setting.The study found that there was no significant going away between the effect of intranasal fentanyl and intrave nous morphine sulphate in pain reduction. The study identified that there were no previous randomised controlled trials available. The lack of backup evidence for analgesics have been identified by Borland, Jacobs and Rogers (2002) who also recognised that there was paucity of data to support practice with no randomised trials.Moreover a trial by Borland, Jacobs and Rogers (2002) further confirmed that intranasal fentanyl was comparably effective at reducing pain paediatric in an emergency department.The study had several limitations, including the ideal size, which was set out to be 400 patients. Due to time constraints, a total of 258 patients were randomised and out of them, only 227 were evaluable. Also, the side effects were observed by paramedics who were treating the patients, which may have produced biased results. The author notes that a more reliable way of recording such data would be by a adept physician or dedicated paramedic researcher who would not be busy with cli nical care.The study notes that nausea and vomiting may still be a problem with the use of fentanyl, especially in the mucosal routes and particularly in children, as they may become uncooperative. It has also been noted that the ability to accept any medication through nostrils changes throughout the day, because of mucous congestion. Following this conclusion, some Australian ambulance services increased the doses of intranasal fentanyl with reported beneficial outcomes.In conclusion, it is clear that the pain management in paediatric population continues to evolve not only in pre-hospital setting within the United Kingdom, but also around the world where doctors are using their experience with synthetic analgesia to drive the patient care further, broadening the scope of emergency practitioners, such as paramedics employed by UK NHS Ambulance trust.In 2003, morphine sulphate was introduced and marked as a solution to ever increasing problem with oligoanalgesia. More recently, co mplex studies evaluated the risk to benefit ratio of alternative analgesia more suited for specific part of our population, such as the use of intranasal fentanyl for paediatric patients.Moreover, the essay demonstrated that the improvement must start with clinicians, their understanding of protocols and ways to treat aforementioned group of patients.Paediatric patients seldom need medication for the relief of pain. They tolerate discomfort well.This citation clearly demonstrates how far the care for paediatrics in acute pain has come in recent decades and thanks to the research mentioned throughout the essay, it continues to improve within a hospital as well as pre-hospital setting.

Animal Influences in Paleolithic, Egyptian and Greek Art Essay

Animal Influences in Paleolithic, Egyptian and Greek Art in that respect are numerous ways in which animals have resonated within thehuman mind. Throughout history there have been representations rangingfrom the realistic, to myths, legends, symbols, and evening horrific murderousbeasts at the same time providing fascinating perspectives of our ownhumanity. Various forms of imposture have conveyed ideas and concepts ofanimals intelligence, as well as behavior, from generation to generation.Animal art is used as a tool to make the connection between differentcultures at different time periods and it relates historical and symbolicmeanings. In approximately cultures animals have been linked with the supernaturalforces which were believed to control the natural world and the destiny ofhumans. They were often revered as the agents. or associates, of gods,and goddesses, and were even the focus of worship as deities. Followingthe tracks of historical animal art, through the human imag inationintroduces a trail of creativity and unsurpassed beauty.Paleolithic artCave paintings are the earlier known example of human art dating40,000 to 8,000 BCE. The paintings mainly feature various animalsrunning, sleeping, and eating. Some also contain a few humans,geometrical shapes, and even hand prints. The artist used permanentfeatures like ceilings, floors, and walls of rock shelters and caves as theircanvas. Pigments of black, yellow, red, and brown were utilized to displaythe observations of animals. The painters gathered a great deal of training about finding food, and which foods were safe to eat or tohunt, by closely observing animals. The valuable information was passed toothers through the detailes in the... ...Avery, Catherine B. The New Century neoclassic Handbook. New York, 1962Beckett, Sister Wendy. The Story of Painting. New York, 1994Boardman, John, Greek Art. London, 1964Durant, Will. Our Oriental Heritage. New York, 1935Fleming, William. Arts & Ideas. New Yo rk Gombrich, E. H. The Story of Art. London, 1967Hall, James. Dictionary of Subjects & Symbolism in Art. New York, 1974Kirk, G. S. The character of Greek Myths. New York, 1975Janson, H. W. History of Art. New York, 1969Leroi-Gourhan, Andre. Treasures of Prehistoric Art. New York MacClintock, Dorcas. Animals Observed. New York, 1993Metropolitan Museum of Art. Treasures of Tutankhamun. New York, 1976Richter, Gisela M. A. A Handbook of Greek Art. New York, 1987Scranton, Robert L. Aesthetic Aspects of antique Art. Chicago, 1964Stockstad, Marilyn. Art History. New York, 1995

Blue Hotel :: essays research papers

It is not surprising for an authors background and surroundings to profoundly affect his writing. Having come from a Methodist gillyflower and living at a time when the church was still an influential facet in peoples daily lives, Stephen stretch was deeply instilled with spectral dogmas. However, fear of retribution soon turned to cynicism and criticism of his idealistic parents God, "the wrathful Jehovah of the Old Testament" (Stallman 16), as he was confronted with the harsh realities of war as a journalistic correspondent. Making extensive use of religious metaphors and allusions in The Blue Hotel (1898), Crane thus explores the interlaced themes of the sin and virtue. Ironically, although "he disbelieved it and hated it," Crane simply "could not free himself from" the religious background that haunted his entire life (Stallman 5). His father, a well-respected reverend in New Jersey, advocated Bible reading and preached "the castigate way." Si milarly, his mother, who "lived in and for religion," was influential in Methodist church affairs as a speaker and a journalist in her crusade against the vices of her sinful times (Stallman 5). This emotional frenzy of revival Methodism had a strong impact on young Stephen. Nonetheless, he -- falling short of his parents expectations on moral principles and spiritual view -- chose to reject and defy all those abstract religious notions and sought to probe instead into lifes realities. Moreover, Cranes genius as "an commentator of psychological and social reality" (Baym 1608) was refined after witnessing battle sights during the late 19th century. What he saw was a stark contrast of the peacefulness and ethical motive preached in church and this thus led him to religious rebelliousness. As a prisoner to his surroundings, man (a soldier) is physically, emotionally, and psychologically challenged by natures indifference to humankind. For instance, in the story, &quo twhat traps the Swede is his fixed idea of his environment," but in the end, it is the environment itself -- comprised of the Blue Hotel, Sculley, Johnnie, Cowboy Bill, the Easterner, and the saloon gambler -- that traps him (Stallman 488). To further illustrate how religion permeated into Cranes writing, many scenes from The Blue Hotel can be cited. Similar to the biblical Three Wise Men (Stallman 487), three individuals out of the East came traveling to Palace Hotel at Fort Romper. The issue explored is the search for identity and the desire of an outsider (the Swede) to define himself through conflict with a society.

Tulsa Race Riots Essay -- essays research papers

Tulsa belt along RiotThe Tulsa ply riot changed the course of American account by actively expressing African American views on flannel supremacy. Before the events of the Tulsa zip riot African Americans saw the washrag community taking justice into their own hands. Black citizens of Tulsa stood up against this sort of white mob. This escaladed into the Tulsa wash riot. The Tulsa extend riot and its effects weighed heavily upon the African Americans of this era.The first event was with the Industrial Workers of World (IWW), where they were blamed by Tulsans in onslaught the house of a wealthy oilman. It began on October 29, 1917, when the home of a wealthy oilman was bombed in Tulsa. There were little clues to be found but as Scott Ellsworth reports in his book Death in a Promised Land, The newspapers were pointing the blame to the IWW(25). The secretary of the IWW was going to be the spokes person for the twelve members of the IWW in court, with the accusation of battery t he house of a wealthy oilman. Ellsworth reportsThe trial was brought to a speedy conclusion. Not only did Judge Evans find the twelve guilty, fine them $100 each, and committed them to jail, but five mickle in the courtroom who had served as witnesses for the defense arrested. The police were then instructed to transfer the seventeen prisoners that night to the county jail(30). The police officers escorted the seventeen men into cars and took them to the county jail, but on the way they were halted by a group of armed men, which called themselves Knights of Liberty. Knights of Liberty took the seventeen men out of the car and tied them to the tree. As Ellsworth reports, They were wiped on their stick out and then hot tar and feathers were then applied to the bloodied tail ends of the seventeen men (30). The second event, which showed that white Tulsans were hostile before the Tulsa Race Riot, was when Roy Belton killed Homer Nida a taxi car drive. On August 21, 1920, Nida was dr iving two white men and one white woman to a dance in flushed Fork. While driving Nida notice something unusual about his passenger. Just before cherry Fork, as Scott Ellsworth writes that Nida was clubbed on the head by on of the men with a revolver (30). They got outside of Red Fork were Nida was then shot in the stomach by one of the men in the car. Roy Belton a white fountain telephone company worker took a rid... ...sa (60). The commission of Tulsa has been working since 1997 to create a better picture of the violence that led to the destruction the citys black business district. The magazine the Jet report, that the commissioners recommended restitution ranging from a memorial and scholarships to direct payments to survivors and their descendants (9). There is also been a controversy about the issue of deaths during the Tulsa race riot. In 1999 historians came to Tulsa trying to find the correct calculate of deaths. In a Goble-News article historians believe close to 300 mickle died during the violence of the Tulsa race riot (n.pag.). In all black citizen of Tulsa became very close do to this tragedy that accrued on June 1, 1921. The Tulsa race riot changed the course of American tale by actively expressing African American views on white supremacy. Certainly I feel with the available facts in this research paper, that the whites were the aggressors for the events leading up to the Tulsa race riot and the start of the Tulsa race riot. African Americans were simply there to stand up against the white supremacy and to provide the African Americans Tulsa their freedom and equal justice. Tulsa Race Riots Essay -- essays research papers Tulsa Race RiotThe Tulsa race riot changed the course of American history by actively expressing African American views on white supremacy. Before the events of the Tulsa race riot African Americans saw the white community taking justice into their own hands. Black citizens of Tulsa stood up against thi s sort of white mob. This escaladed into the Tulsa race riot. The Tulsa race riot and its effects weighed heavily upon the African Americans of this era.The first event was with the Industrial Workers of World (IWW), where they were blamed by Tulsans in bombing the house of a wealthy oilman. It began on October 29, 1917, when the home of a wealthy oilman was bombed in Tulsa. There were little clues to be found but as Scott Ellsworth reports in his book Death in a Promised Land, The newspapers were pointing the blame to the IWW(25). The secretary of the IWW was going to be the spokes person for the twelve members of the IWW in court, with the accusation of bombing the house of a wealthy oilman. Ellsworth reportsThe trial was brought to a speedy conclusion. Not only did Judge Evans find the twelve guilty, fine them $100 each, and committed them to jail, but five people in the courtroom who had served as witnesses for the defense arrested. The police were then instructed to transfer t he seventeen prisoners that night to the county jail(30). The police officers escorted the seventeen men into cars and took them to the county jail, but on the way they were halted by a group of armed men, which called themselves Knights of Liberty. Knights of Liberty took the seventeen men out of the car and tied them to the tree. As Ellsworth reports, They were wiped on their back and then hot tar and feathers were then applied to the bloodied backs of the seventeen men (30). The second event, which showed that white Tulsans were hostile before the Tulsa Race Riot, was when Roy Belton killed Homer Nida a taxi car drive. On August 21, 1920, Nida was driving two white men and one white woman to a dance in Red Fork. While driving Nida notice something unusual about his passenger. Just before Red Fork, as Scott Ellsworth writes that Nida was clubbed on the head by on of the men with a revolver (30). They got outside of Red Fork were Nida was then shot in the stomach by one of the men in the car. Roy Belton a white creator telephone company worker took a rid... ...sa (60). The commission of Tulsa has been working since 1997 to create a better picture of the violence that led to the destruction the citys black business district. The magazine the Jet report, that the commissioners recommended restitution ranging from a memorial and scholarships to direct payments to survivors and their descendants (9). There is also been a controversy about the number of deaths during the Tulsa race riot. In 1999 historians came to Tulsa trying to find the correct number of deaths. In a Goble-News article historians believe close to 300 people died during the violence of the Tulsa race riot (n.pag.). In all black citizen of Tulsa became very close do to this tragedy that accrued on June 1, 1921. The Tulsa race riot changed the course of American history by actively expressing African American views on white supremacy. Certainly I feel with the available facts in this research pap er, that the whites were the aggressors for the events leading up to the Tulsa race riot and the start of the Tulsa race riot. African Americans were simply there to stand up against the white supremacy and to provide the African Americans Tulsa their freedom and equal justice.

The History Of The Modem :: Technology History

The modem, which is an acronym for modulator/demodulator, was invented in the 1950s for military machine use. Manufactured by the now popular computer company, IBM, modems were used as reveal of an air-defense system their purpose was to connect various airbases and control centers. Modems are devices that commix (modulate) and separate (demodulate) signals, allowing superstar computer to connect to another. They transportation system the data over telephony lines by using analog waves and the modem then converts the waves back and forth. The first modems were intentional to hold a telephones receiver in a cradle and had wire connections that went from the cradles to the computer. Today, close to modems are either internal or international hardware devices. in front the computer modem, there was the com-port. When an internal modem card is placed inside of a computer, it behaves as a COM2 or COM3 port. It is also possible connect serial mice into one of these ports (Gi lbert, 1996). Asynchronous communication is used in the PC COM port. Each byte of data is a separate unit and the computer that is sending the data can divulge between any two bytes of the message. However, the receiver of the message may have to enamour the data as quickly as it arrives. This is done by the a synch data requiring one extra bit worth of time to announce the brand-new bytes beginning and in one case extra bit worth of time at the end. This is what is known as the fall out and stop bits. This means that a 2400 baud modem could transfer only 240 bytes of data per second. Each byte would require a minimum of 10-bit times. This was once called start-stop communication, but asynchronous (a sync, for short) is the name (Gilbert, 1995). The modem does not start and stop the bits. They are genuinely put out as part of the general data compression. The start and stop bits continue to be generated on the wire that connects a COM port to an external modem. The m odem COM port is generally configured to use a higher invigorate between the modem and the COM port than what the actual transmission will support. A modem may steer at 14,400-kbps with the COM port configured for 38,400-kbps. This is an example of older technology universe adapted to meet new requirements (Gilbert, 1995).The History Of The Modem Technology HistoryThe modem, which is an acronym for modulator/demodulator, was invented in the 1950s for military use. Manufactured by the now popular computer company, IBM, modems were used as part of an air-defense system their purpose was to connect various airbases and control centers. Modems are devices that mix (modulate) and separate (demodulate) signals, allowing one computer to connect to another. They transfer the data over telephone lines by using analog waves and the modem then converts the waves back and forth. The first modems were designed to hold a telephones receiver in a cradle and had wire connections that wen t from the cradles to the computer. Today, most modems are either internal or external hardware devices.Before the computer modem, there was the com-port. When an internal modem card is placed inside of a computer, it behaves as a COM2 or COM3 port. It is also possible connect serial mice into one of these ports (Gilbert, 1996). Asynchronous communication is used in the PC COM port. Each byte of data is a separate unit and the computer that is sending the data can pause between any two bytes of the message. However, the receiver of the message may have to catch the data as quickly as it arrives. This is done by the a synch data requiring one extra bit worth of time to announce the new bytes beginning and once extra bit worth of time at the end. This is what is known as the start and stop bits. This means that a 2400 baud modem could transfer only 240 bytes of data per second. Each byte would require a minimum of 10-bit times. This was once called start-stop communication, but asynchronous (a sync, for short) is the name (Gilbert, 1995). The modem does not start and stop the bits. They are actually put out as part of the general data compression. The start and stop bits continue to be generated on the wire that connects a COM port to an external modem. The modem COM port is generally configured to use a higher speed between the modem and the COM port than what the actual transmission will support. A modem may operate at 14,400-kbps with the COM port configured for 38,400-kbps. This is an example of older technology being adapted to meet new requirements (Gilbert, 1995).