Abortion Pregnancy and Unwarranted Government Intrusion Free Essays

Fetus removal Ever since the thought/choice of premature birth there has been contentions in the event that it is good are most certainly not. A lot of individuals are unequivocally against it and state generally excellent data on why yet I’m expert premature birth. I’m genius premature birth since as a matter of first importance it should be up to ladies if its lawful or not on the grounds that its their bodies that need to experience the procedure of fetal extraction. We will compose a custom exposition test on Fetus removal: Pregnancy and Unwarranted Government Intrusion or then again any comparative point just for you Request Now There are a few conditions wherein a premature birth is required. Lets state a secondary school couple happens to get pregnant they’re not entirely competent to deal with a child and be guardians. A child would exacerbate the previously existing issues a youngster as of now has like school, sports, preparing for school. That is not life for an infant particularly an undesirable one, what sort of personal satisfaction is that for the infant or guardians. Imagine a scenario where the hopeful guardians of that infant aren’t fit to be guardians having issues with medications and liquor nobody ought to grow up around that. On the off chance that the infant did it might follow in the degenerate strides of its bombing guardians and wind up doing likewise things. In the event that ladies are compelled to convey undesirable pregnancies to term the outcome is undesirable youngsters which then when they grow up are off guard, and at times slanted toward fierce conduct to other people. Presently even God restrict let’s state some lady had been assaulted and she has gotten pregnant hence, she is likely going to need a fetus removal. This may sound disgusting and mean yet what ladies would need to keep that infant and take a gander at the person in question and consistently and be helped to remember that time where she was exceptionally defenseless and being exploited. Nobody ought to need to continue remembering that second again and again that would be horrendous. Presently the large issues why fetus removal ought to be lawful turned out in the 1973 instance of Roe versus Wade. This case went along after ladies began having off camera premature births where ladies had it done by coat holders and messy instruments to play out these profoundly risky techniques typically done on themselves or purchase a paid individual who has done these ghastly methodology previously. Most ladies would wind up having genuine contaminations, interior draining and now and again even passing. So fetus removal ought to be legitimate so we don’t have this back-room methods any longer and ladies having lethal wounds. In any case, on the off chance that they as of now have a genuine sickness or complexity, for example, coronary illness, kidney malady, serious hypertension, sickle-cell iron deficiency and extreme diabetes. The accessibility of lawful fetus removal can help advert genuine clinical issues that can happen from labor. In the event that fetus removal was illicit the administration would push a â€Å"undue burden† on ladies as well as families which is unlawful at any rate in light of the fact that the legislature can not interrupt an individual or people life like that. What's more, when a fetus removal is completed a ladies just has 90 days to have on done or it gets unlawful in any case. (the trimester law that was built up in the Roe versus Wade case)  We ought not interfere with ladies as well as families matters by saying what they can and cant do seeing issues, for example, these, premature birth is even ensured by the fourteenth amendment which gives ladies right to security. We should regard and bolster a lady and her family as they face the life changing choice of whether to have a kid or not. So its not about the way that you are as far as anyone knows â€Å"killing† an unborn baby its more that we have the choice and the alternative to do what that individual needs to do. For certain families an incidental pregnancy is alright however for whatever an occasion can be very  catastrophic. It can bring about increment pressures, upset dependability and put path underneath the line of financial endurance. The prohibiting of fetus removal would likewise be oppressive towards the poor ladies and families that must retreat to the risky self-instigated or back rear entryway methods. Men with these well off families can send their spouses or sweethearts to different nations and pay to have it done legitimately. It will likewise whenever prohibited make more youngsters bear kids considers show that 44% of multi year old young ladies will get pregnant before they turn twenty. This could happen to your little girl or some other cherished one. Premature birth and conceptive opportunity all the more extensively characterized are significant bits of guaranteeing this normal dream. To acquire a superior future, we should each be allowed to settle on significantly close to home choices about our regenerative lives without ridiculous government interruption. Similarly as with all opportunities, there are limits. Be that as it may, a legislature that regards the individual respectability of its kin both meddles in these basically private choices as meager as could be expected under the circumstances and guarantees that everybody has the chance to settle on these choices dependably. So by and large there are a couple of conditions where a premature birth is required, for example, youth, clinical intricacies that can be turned away, and could mess major up for the family and the unborn youngster. This is the reason I feel that premature birth ought to be legitimate despite the fact that what the individuals against fetus removal are stating and attempt to toss in your face and cause you to accept. They have no proof for their investigations cause there is no confirmation behind what they state. The baby can not feel torment before the primary trimester (90 days) and no where in the good book does it say that its wrong since when the holy book was composed premature births weren’t even around at the time not to mention thought of. Step by step instructions to refer to Abortion: Pregnancy and Unwarranted Government Intrusion, Essay models

Anime Essay Example For Students

Anime Essay Did some exploration, since I dont truly follow refreshes for craftsmen. Utada Hikaru has discharged another collection some time back this year called This is the One and in there, one of the melodies grabbed my eye. The melody is called Merry Christmas Mr. Lawrence FYI. Why this tune? Since the initial music is some way or another extremely oriental and it was a revamp melody from the fundamental subject of the film Merry Christmas Mr. Lawrence. I dont truly know why she pick this music to sing, yet all I know is that Merry Christmas Mr. Lawrence primary signature music has been changed a great deal of times. Delineated from Wikipedia, Merry Christmas Mr. Lawrence FYI sang by Utada Hikaru, the verses reference to the film also. Since Im no devotee of old motion pictures, particularly those during the 80s 90s (obviously, I despite everything like P. Ramlees motion pictures), it kept me inquisitive to need to watch the film. The principle signature music was made by Sakamoto Ryuichi, an extremely alleviating tune and was positioned among the best in his music. Some redo adaptations, duplicated glue here: There is a 12 vinyl revamp form on the renowned Italian record mark DISCOMAGIC named Clock On 5 Theme From Furyo. A spread rendition of Forbidden Colors is remembered for Hollywood Mon Amour, an assortment of tunes put on the map by their incorporation on soundtracks of motion pictures made during the 1980s, adjusted by Marc Collin of Nouvelle Vague with Nadeah giving the vocals. In 2000, a re-blend of Ryuichi Sakamoto s Merry Christmas Mr. Lawrence called Heart of Asia was discharged in Europe by move bunch Watergate. In 2008, Indonesian vocalist Anggun utilized an example from this tune on Hymne a la compete a track on her collection Elevation. In 2009, Japanese-American pop vocalist Hikaru Utada utilized an example from this melody on her second English-language collection This Is the One, entitling her tune Merry Christmas Mr. Lawrence FYI. . The verses reference to the film also. The tune is additionally utilized (in altered structure) as the signature melody to the Atari XE port of International Karate (for the Sydney stage) Japanese Post-Hardcore band FACT recorded a track by the title Merry Christmas, Mr. Lawrence on their self-titled collection.

What I Have Learned From The Early Decision Process At MIT

What I Have Learned From The Early Decision Process At MIT *Update as of 2015: Early action is available to both domestic and international students. As you can see by the photos, this was a grueling process. I could go through it step by step with you, but Bens already covered that. So lets get to the meat of the matter (or for you vegans out there, the shiitake mushroom of the matter). Here are some of the things that impressed me: The quality of the essays. I was constantly floored by the way so many of you approached your essays and your overall style and flow. Dare I say, I saw flashes of brilliance every now and again? I SO wish that I could share snippets of some of the essays that I reviewed. Alas, under penalty of law and all that stuff concerning your right to privacy, I am forced to discuss them using only my inner voice. The fine ways that many of you give back to the community. It is not hard to tell when someone is just going through the motions or trying to pad their application. I saw true selfless activities. This includes everything from the creation of clubs in school to activities that help to relieve human suffering to activities that help to right injustices. It is humbling to see so many students showing so much compassion for their fellow man. The great ways that you spend your free time. (Although, I do wish all of you would sleep more!) Other than hang out on my blog, I am pleased that you are having fun, that many of you have such a great sense of humor! The amount of passion in your applications. WOW! It does the soul good to know that you love this stuff. Some of you have been doing things related to your intended fields of study for quite some time, while others of you are chomping at the bit to jump right in. As the Black Eyed Peas said, Lets Get it Started in Here. (DISCLAIMER: Do not assume that you wont be admitted if you have not already pursued a great deal of activity in your intended field of study. We know that an interest in creative writing is easily expressed as compared to one in Nuclear Engineering. In other words, we believe that writing samples make fine submissions, whereas we REALLY discourage the submission of fusion reactor cores, no matter how much lead you use as packing material. A low geek factor. Normal students apply and will be accepted to MIT. If what you do makes you a geek in HS, itll make you a superstar at MIT.

The Pursuit Of Women s Rights Essay - 1839 Words

Since the beginning of history, men have always been considered the innate leaders of any society. They are considered to be aggressive, dominant, smart for business, and born to be leaders. Conversely, to women who since early history had to break stereotypes to show that they had the potential to work and prove themselves to hold powerful positions at work. Due to the pursuit of women s rights and equality to men, known as feminism, history has changed. Different from decades ago, women are now entitled to choose between working and staying at home, they have more options than just being a wife and a mom. While, women now have rights, they still carry different stereotypes that sometimes prevent them to be respected and considered for a better position at the workplace. Stereotypes of women such as sensitive, unstable, deep emotional are some of the reasons why women are not considered potential leaders. That is why, as Ariel Levy discusses in her essay â€Å"Female Chauvanist Pig s† â€Å"Women who ve wanted to be perceived as powerful have long found it more effective to identify with men than to try and elevate the entire female sex to their level† (268). Instead of fulfilling the designated stereotypes, women are showing that they can have a masculine side too. In order to be considered as powerful leaders in a male dominated society, most women try to identify with men by acquiring masculine characteristics.Although, the successful leadership style is masculine, womenShow MoreRelatedFrankenstein Pursuit Of Knowledge Essay1673 Words   |  7 Pages Among the many themes explored in Mary Shelley s timeless classic â€Å"Frankenstein†, the one I find to be most relevant and the one that truly resonated with me was the dangers that stem from the pursuit of knowledge. 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What lied in the foreground of the civil war are images of unions and confederate soldiers rummaging through forest of the American South and thoughts of slaves gaining their long sought freedom. However most people do not consider the lingering backdrop of the war. That would be the effects the war would have on the changing gender roles. The new gender roles formedRead MoreGender Inequality1640 Words   |  7 Pagesinequality issue: the grievances of women. Feminists have fought against the ingrained tradition of women as housewives with no rights and being looked down upon as the lesser sex. The women’s rights movement in the United States has worked tirelessly since 1848 to fight for rights and break down gender barriers. Misogyny and gender constructs, such as the ideal of beauty, hold women back in various aspects of their lives as discussed in the articles â€Å"Marked Women† by Deborah Tannen and â€Å"A Woman’s

Hydration management in acute stroke patients - Free Essay Example

Sample details Pages: 12 Words: 3680 Downloads: 4 Date added: 2017/06/26 Category Statistics Essay Did you like this example? Introduction Stroke is a global public health concern with many sufferers presenting with varying levels of confusion (Oh and Seo 2007). Management of hydration in acute stroke patients is not standardised and variations in practice can be very wide between different continents. The sheer number of possible comorbidities and the relative ease with which hydration can trigger concomitant problems can lead to increasing incidence and prevalence of long-term patient care resulting from inadequate hydration management. Don’t waste time! Our writers will create an original "Hydration management in acute stroke patients" essay for you Create order Optimum hydration assessment and management are key clinical activities; however, inadequate hydration controls by health professionals persist (Oh and Seo 2007). Research shows that to guide fluid management to desired levels, a regular assessment of the volume status has to be made Scope This literature review is based on works that are found on Medical Literature Analysis and Retrieval System Online (MEDLINE), the Cumulative Index to Nursing and Allied Health literature (CINAHL), Cochrane, Department of Health (DoH), National Institute of Clinical Excellence (NICE), National Medical Council (NMC), World Health Organisation (WHO), Wiley Interscience and CKS databases that relate to hydration in stroke patients and nursing awareness of hydration in stroke patients. There is wide literature on different aspects of stroke and many authors have studied the effects of hydration in stroke patients. This review looks at literature that discusses management of hydration and/or the impacts of variations in hydration management on acute stroke patients outcomes like method of feeding, time- compliance in taking readings or measurements, legal issues and ethical issues. Relevance to clinical practice This literature review looks at relevant studies by experts that are found on credible databases. The purposes of the expert studies are reviewed and analysed to inform better understanding of current nursing practice in hydrating acute stroke patients. Several studies on hydration highlight specific difficulties relating to the assessment and management of hydration in acute stroke patients. There are differences between the management and the assessment of hydration in different hospitals and these complicate improving awareness of managing hydration for nurses in practice. If optimum hydration is directly linked to improved outcomes in acute stroke patients, research will be required to identify and overcome barriers to effective hydration management, including the development of specific tools (and knowledge base) to facilitate interventions that promote optimum hydration in seeking improved outcomes in acute stroke patients. Methods of search and documentation n on-line literature search of MEDLINE, CINAHL, COCHRANE, DOH, NICE, NMC, WHO and CKS from 1999 to May 2009 failed to identify enough relevant articles on hydration in stroke patients. Other sources were then reviewed for available literature on medical journals including the BMJ and American Family Physician. For the on-line computer-based literature searches, the following keywords were used: stroke, fluid balance, hydration, cerebrovascular accident (CVA), dehydration, stroke outcome, cerebrovascular disorders, medical management, artificial nutrition and hydration, dysphagia, dysphasia, pyrexia, acute brain infarction, enteral tube feeding, fluid and electrolyte balance, neurology, withholding treatment, pathophysiology and nurses and hydration Hydration and hydration management in acute stroke patients This literature review looks at one of the issues encountered globally in the treatment of acute stroke patients optimum hydration. It takes a particular look at the nursing awareness, measurement, assessment, methods of intervention and the legal issues associated with hydration in acute stroke patients. Stroke is a debilitating condition and can be caused by an ischaemic event or a subarachnoid/intracerebral bleeding. Stroke patients usually present in hospital with co-morbidities (Oh and Seo 2007). Variations exist in stroke fatalities across geographical regions even within the same continent. Studies by Bhalla et al (2003) across four European centres (London, Dijon, Erlangen and Warsaw) have shown significant variation (after adjusting for case mix) in stroke case fatality, in incontinence, dysphasia, dysphagia, conscious level, pyrexia, hyperglycaemia and comorbidity. There were also significant intervention differences between centres in intravenous fluid use, enteral feedin g, initiation of new antihypertensive therapy and insulin therapy, with the London centre having the lowest uptake of interventions. In another European BIOMED Programme, significant variations in case fatality for stroke between European centres (after adjustment for stroke severity) were observed, with the United Kingdom (UK) centres having the highest case fatality and the lowest levels of independence (Wolfe et al., 1999). There were lower intervention rates in the UK centre to correct abnormal physiological parameters in the acute phase which may reflect a difference in philosophy of acute medical supportive care compared with other European countries (Wolfe et al., 2001). Awareness of optimal hydration balance and assessment of the patients hydration condition (in the care of acute stroke patients) is a fundamental part of critical care nursing and optimising the hemodynamic situation can be seen as a team-effort. One of the important factors determining quality of the circula tion is the amount of circulating blood (Hoff et al 2008). Following a stroke, patients may have swallowing impairment and other changes of the gastro-intestinal (GI) tract that could affect nutritional and hydration status and that lead to aspiration pneumonia (Schaller et al 2006). Such changes affect the ability of the acute stroke patient to lead a normal nutritional life. Although the Schaller et al (2006) work did not show a direct link between hydration and other comorbidities, they agree that impaired hydrational status is associated with reduced functional improvement, increased complication rates, and prolonged hospital stays. Hydration and hydration status Hydration balance is a measure of the bodys ability to manage fluids and electrolytes. In order to identify the urgency of interventions, nursing staff should characterize an individuals fluid and electrolyte imbalance as mild, moderate, or severe based on pertinent information including lab tests and other relevant criteria. It is important to recognize that the main electrolyte in extracellular fluid (ECF) is sodium and that of intracellular fluid (ICF) is potassium (Edwards, 2001). Toto (1998) pointed out that large increases or decreases in fluid volume can cause infarct, coma and confusion. This knowledge becomes significant in maintaining cerebral blood flow and in preventing secondary brain insult after an acute stroke. In a complication, respiratory or metabolic acidosis will promote the movement of potassium from the ICF and give rise to high serum potassium levels, which may affect cardiac function (Edwards, 2001). This phenomenon can be seen in many traumatic insults to th e brain. A basic knowledge of this physiology in addition to the homeostatic mechanisms for fluid and electrolyte balance is a vital foundation for nursing practice, and essential to the nurses role in hydration management. Cook et al (2005) highlighted the significance of fluids and hydration in the neuroscience patient and in Cook et al (2004) they highlighted that an understanding of the physiological mechanisms that surround stroke is important for nurses to monitor and treat such patients. Kelly et al (2004) in their study of dehydration and venous thromboembolism (VTE) after acute stroke believed dehydration after acute ischaemic stroke (AIS) is strongly independently associated with VTE, reinforcing the importance of maintaining adequate hydration in these patients. Their study of hydration over a 9-day period showed indication that dehydration was largely hospital acquired and that the association was causal. Although the possibility that VTE was already present at entry to hospital cannot be discounted, tests have shown that VTE is rarely present before the second day post stroke, and then it becomes increasingly prevalent over the next few days. This could be for one of many reasons including poor communication between patient and hospital staff, change of environment for the patient and the physiological impacts of stroke Hydration balance and nutritional/electrolyte balance The differences in how hydration is assessed in different hospitals have been subject of study for some time. The significance of fluid electrolyte homeostasis becomes very relevant in trauma and shock situations such as subarachnoid haemorrhage where an inflammatory response is triggered which causes a significant change in capillary membrane permeability in a short period of time. In such situations, water, electrolytes and albumin move into the interstitial space to permit the site of injury to receive the required factors (third space shift) (Edwards, 2001). A number of physiological mechanisms are required to maintain homeostasis of hydration status, all of which inform proactive nursing assessment, intervention and evaluation. Those with trauma to the nervous system are vulnerable to disruption to the homeostasis of fluid and electrolyte balance (Cook 2005). Older adults may have a poorer capacity to adapt to shifts in acute fluid balance, leading to the possibility of cardiac and renal functions being impaired and, as a result, a lower glomerular filtration rate (Sheppard, 2001). Managing the fluid balance of the stroke patient by intake and output measures needs to be exercised cautiously because even though the patients fluid volume may not have changed, his/her circulatory volume may be significantly lower in instances of major trauma (Edwards, 2001) Good hydration has been shown to reduce the risk of urolithiasis (category Ib evidence) (see Appendix 2), constipation, exercise asthma, hypertonic dehydration in the infant, and hyperglycemia in diabetic ketoacidosis (all category IIb evidence), and is associated with a reduction in urinary tract infections (UTIs), hypertension, fatal coronary heart disease, venous thromboembolism, and cerebral infarct Complications of measurement/control Naso-gastric v PEG, enteral v parentera Patient history taking on presenting in the hospital differs from hospital to hospital. History taking should include assessment of fluid intake and loss, baseline hydrational status, skin turgor, heart rate, blood pressure and urinary output. Normal fluid intake for the average adult is approximately 2-2.5 litres, obtained from food, fluids or metabolic by-products (Edwards, 2001). Methods of measurement are not standardised across hospital settings with Wise et al (2000) showing that faecal fluid losses are often neglected in daily fluid balance charts with the possibility of inaccurate hydration assessment. Fluid assessment must include estimating, as accurately as possible, the quantity of fluid taken in. It must take into consideration the entire processes by which water, potassium and sodium are obtained. Measurements are often mainly focused on the extremes of hydration (optimal hydration and extreme dehydration) and this should not be the case. Assessment of hydrational statu s and need is continuous and begins somewhere along a continuum of severe hypovolaemia/ dehydration to severe hypervolaemia/ overhydration. In looking at dehydration, not only extreme dehydration should be noted. Manz and Wentz (2005) highlight that there is increasing evidence mild dehydration may also account for many morbidities and play a role in various other morbidities. The way in which stroke is managed acutely, such as measures maintaining physiological homeostasis may also vary between different populations (Bhalla et al 2003). The physiological indicators of acute deficits in fluid balance may be masked in individuals where compensatory mechanisms are intact. A history of acute events, mainly from baseline documentation and history taking, may enable better identification of such imbalances (Sheppard, 2001). Fluid and electrolyte homeostasis is brought about by the interaction between the renal, pulmonary, neuroendocrine, integumentary and gastrointestinal systems (Edward s, 2001). According to (Cook 2005), fluid and electrolyte management is a fundamental aspect of the role of the neuroscience nurse. Artificial feeding and fluids are the options for a patient who has an advanced, life-threatening illness and is dying. The patient, family members and doctor can talk about these options and the benefits and risks (Ackermann 2000). Hydration and electrolyte status are crucial mediators to the extent of the neuro-hormonal response to trauma. Edwards (1998, 2001) highlighted that homeostasis is maintained by a constant movement of water, sodium and potassium between intra- and extracellular compartments. While the movement of water and electrolytes between the cellular compartments is highly significant, it is important to recognize that in acute and chronic illness intracellular fluid (ICF) is reduced and extracellular fluid (ECF) increased almost to the extreme (Edwards, 2001). This is highly relevant for cerebral metabolism, because transport of oxyge n, glucose, proteins and other products for cellular metabolismà ¢Ã¢â€š ¬Ã¢â‚¬ and their by-productsà ¢Ã¢â€š ¬Ã¢â‚¬ may be severely impaired. Stroke may affect ones level of alertness, perception of thirst, ability to access liquids, and ability to swallow them when offered. Stroke victims with such impairments may be at increased risk for diuretic-induced dehydration (Churchill et al 2004). Managing hydration balance is of crucial importance and the mechanisms for the adequate monitoring and controls need to be in place. Nursing management questions in the assessment of hydration in acute stroke patients should include whether use of intravenous fluids during the first week of stroke was recorded. Questions should also include whether the patient was fed orally, by nasogastric tube, through percutaneous gastrostomy tube, by intravenous methods or not at all? The fact that these questions can be raised enforces the need for adequate documentation and recording of acute stroke pa tient records. Bhalla et al (2002) says that the use of artificial ventilatory support with intubation or nasal intermittent positive pressure ventilation should be documented as well as the use of supplemental oxygen given through nasal catheters or masks. Enteral tube feeding is a vital means of feeding and balancing hydration levels in patients with stroke. There are no set standards for hospitals in the UK and hospitals have recorded much variation between them in the timing of the start of enteral tube feeding and whether a nasogastric or percutaneous endoscopic gastrostomy (PEG) tube is used (Ebrahim and Redfern 1999). Some clinicians delay tube feeding for 2 weeks or more, and although early nutrition is unlikely to be harmful, whether any nutritional benefits offset the difficulties and complications of initiating and maintaining early enteral tube feeding is unclear. If the timing or route of enteral tube feeding does affect outcome, the present variation in practice means that large numbers of patients are being denied best treatment. Whether enteral tube feeding via PEG rather than nastrogastric tube or early initiation of enteral tube feeding improve outcomes was tested in the FOOD trials and no evidence of significant benefit from PEG rather than nasogastric tube feeding was found. Neither was any hazard from early tube feeding found (The FOOD collaboration 2003). The explanation for any difference between PEG and nasogastric groups is not clear, but one factor might be the effect of a long-term PEG tube on dependency since more patients in the PEG group were still receiving such tube feeding than in the nasogastric group at follow-up (The FOOD collaboration 2003). The survivors in the PEG group were also more likely to be living in institutions and had lower quality of life. Another intriguing finding was the excess of pressure sores in the PEG group, raising the possibility that those with such tubes might move less or be nursed differently. Wea knesses in this test results include insufficient statistical power to exclude more modest differences between groups; no information about the proportion of eligible patients enrolled in each centre; our use of an informal (although reliable and highly predictive) assessment of nutritional status; absence of precise monitoring of patients daily intake of nutrients (rather than fluids); absence of on-site source data verification or collection of information on changing nutritional status (e.g. in-hospital weights); possible bias due to masking of secondary outcome measures. Although compliance was not 100%, this fact results from the inevitable difficulties of adhering to rigid schedules when patients conditions change. Difficulties with nasogastric feeding in stroke patients (who are often confused and uncooperative) have led to increasing use of PEG tubes at an early stage. Enthusiasm for this method has been encouraged by the results of a trial that reported much lower case fata lity rates in patients fed via PEG (13%) rather than nasogastric tube (57%) (The FOOD trial collaboration 2003). Due to significant alterations in fluid balance after enteral tube-feeding in patients, close attention to the recording of fluid balance such as intake/output measurements, body weights and simple bedside assessments is needed to detect fluid imbalances and other serious complications at an early stage (Oh and Seo 2007). One explanation for the varying and inconsistent readings in fluid hydration between enteral and PEG might b Stroke patients and the impacts of stroke on life Difficulty with swallowing is a common problem in acute stroke patients, and can lead to aspiration pneumonia, dehydration, and exacerbation of any existing malnutrition (Finestone and Greene-Finestone 2003). In Oh and Seo (2007) the authors set out to examine the fluid and electrolyte complications after enteral tube feeding in acute brain infarction patients. The background is that inconsistencies in the results of the water and electrolyte complications associated with enteral tube feeding are partly because of uncontrolled disease-related variables. The implication is that these variables were not adequately managed. Stroke patients very often present with dysphagia and this is very commonly dehydration associated with undernutrition (The Food Trial 2005). Up to half of stroke patients in hospital have dysphagia, which precludes safe oral nutrition for the first few days and can persist for long periods (Mann et al 1999). Although a 50% prevalence can be considered to be high, th e nutritional/fluid status of a stroke patient can rapidly deteriorate in hospital. The difficulty in feeding stroke patients with dysphagia coupled with the discomfort associated with stroke can exacerbate undernutrition and/or dehydration. Studies show that undernutrition shortly after admission is independently associated with increased case fatality and poor functional status at 6 months (The FOOD trial collaboration 2003). The current financial burden of efficiency savings and reduced budgets in the NHS hospitals results in reduced staff numbers so that patients can not be attended to on a one-on-one basis so that ensuring appropriate hydration levels is done by periodic but regular monitoring of charts. An option for the future in this area may be to involve the patients family members in hydration monitoring and provide them with appropriate training if evidence can show that being around loved ones improves outcomes and early warnings. In acute stroke, artificial nutrition t hrough an enteral route is needed because of dysphagia and since oral feeding is unsafe in some dysphagic patients, enteral nutrition is often administered as nasogastric or percutaneous endoscopic gastrostomy (PEG) tube feeding (Finestone and Greene-Finestone 2003). Naso-gastric tube feeding (a prevalent enteral method) has been reported to improve clinical outcomes more than the parenteral route in brain-injured patients (Rhoney et al 2002). Oh and Seo (2007) in their study used 85 subjects, but their work was limited by the fact that it was performed retrospectively and some of the subjects records were incomplete. Also, because the patients in the study were from one hospital it is not conclusively known whether the results can be generalised to the whole population./p Legal and other aspects Japanese physicians attitudes towards artificial nutrition and hydration (ANH) as a life-sustaining treatment (LST) were examined to find out if they withhold or withdraw the LST when treating older adults with stroke-caused profound impairment with no hope for recovery. The study findings show that the informants held different views towards LST because most doctors considered ANH to be indispensable and ANH is automatically provided to patients (Aita and Kai 2006). With the advancement of medical technology, decisions to withhold or withdraw LST are among the most difficult to make for health professionals (British Medical Association 2001). Physicians caring for stroke patients often encounter comatose or semi-comatose patients with severe stroke for whom it is difficult to determine whether or not to continue care (Asplund and Britton, 1989). By administering LST, some patients in this patients group, whose bodily functions other than brain function could remain stable, could pot entially survive for months or years without achieving awareness or being able to interact with others (Aita et al 2008). Certain Japanese physicians have criticized the current efforts regarding life prolonging as Aita et al (2008) states: Prolonging the process of dying like this constitutes the violation of dignity and human rights. The life-prolongation only serves hospital operators who want to make profits by keeping hospital beds occupied. They also said this practice impacted the carers and that some nurses also feel emptiness toward the manipulative life-prolongation when taking care of these elderly patients. In the West, some countries have worked out nation-wide guidelines related to withholding or withdrawing LST that say stroke-caused profound impairment with no hope for recovery is a potential reason to withhold or withdraw LST (British Medical Association, 2001). Ackermann (2000) believes withholding and withdrawing therapy challenge family physicians to be excellent communicators with patients and families and recommends that family physicians should continue to be strong advocates for dying patients. Sprung et al (2003) highlighted differences between withholding and withdrawing therapy showing that withdrawal of therapy is followed by a nearer and more rapid death than withholding therapy, and that physicians and nurses were more inclined towards withholding rather than withdrawing therapy. Food and water are considered symbols of caring (Ackermann, 2000), therefore, it may be natural for physicians to give a special status to ANH as food and water. Whether to withdraw ANH from a patient in persistent vegetative state has also drawn substantial media attention in the U.S. (Casarett et al., 2005; Ganzini, 2006). The findings of the study also suggest that the physicians double standard is partly based on their subjective judgment whether the treatment is ordinary or extraordinary. However, the standard of ordinary/extraordinary care has long been criticized as too vague to guide decision-makers in the U.S. (Beauchamp and Childress, 2001). It is believed the current legal framework has also inappropriately led some physicians to simply continue care regardless of the patients conditions, thus resulting in putting an unnecessary burden on patients. The physicians subjective interpretation of the current legal framework may lead to decisions not to initiate mechanical ventilation in some older adults for fear of facing a situation in which physicians cannot withdraw it at a later stage Conclusion Hypovolemia and hypervolemia occurred frequently after acute stroke but were often not recognized as such by nurses. The nurses predictions of current volume status do not seem sufficiently reliable to serve as a basis for therapeutic decisions. More advanced techniques for bedside assessment of volume status may be indicated for optimizing volume status in patients with acute stroke (Hoff et al 2004). Whereas studies have looked at the optimal method of improving hydration, whether correcting dehydration in stroke improves outcome is not very clear. Given the complexity of the cell death cascade following brain ischemia, novel approaches and combination therapy are inevitable for victims of stroke (Fisher and Brott 2003). The review indicates that standards vary from country to country in the legal framework for withdrawing and withholding hydration and nutrition during end stage care.

The Truth About Nuclear Power Free Essays

Nuclear technology has been the cause of more worry than hope. Since its very beginnin g humankind has exploited it for purposes of war rather than for the progress of humankind, but how good is nuclear power for the human race and the environment? By definition of the Merriam -Webster dictionary nuclear means â€Å"of , relating to, or powered by nuclear energy† and energy means â€Å"usable power (such as heat or electricity)†, therefore nuclear energy means usable power powered by nuclear energy â€Å". The reasons behind my choosing of this topic are because few know how nuclear really works and how good it is. We will write a custom essay sample on The Truth About Nuclear Power or any similar topic only for you Order Now Nuclear energy is the source of energy of the future therefore it is something that must concern us in terms of how safe it is for us as humans. Nations like china already have started very ambitious nuclear power plant projects that they hope can give them advantage in the future and I believe that very soon it won’t be just china but the whole world that will have this technology but the question still remains how good is it? All literature cited in this paper has been selected through means of internet and none of it through hard copy books Nuclear Energy At this point in time nuclear energy is something that is still unknown to most of the world, especially the third world. As of now only thirty -one countries in the whole world have nuclear power plants. Reasons for this that I am going to explain are three which are: Disposal of nuclear waste, dramatic accidents that have occurred and the mos t important reason is cost.  Nuclear waste is one of the three big factors preventing nations from considering using nuclear energy. According to the Merriam -Webster dictionary nuclear waste is † radioactive waste material, for example from the use or reprocessing of nuclear fuel†. The reason nuclear waste is such a big problem is that high level radioactive chemicals such as plutonium and uranium act as nuclear fuel for reactors in a nuclear power station but after they have been used they will produce high levels of radiation that is dangerous when exposed to. Nuclear waste is a problem not only for countries thinking about using nuclear energy but those that already do.Nations like the US and its allies foresaw this problem early on and have been making deals with smaller nations to pay them for storing their nuclear waste. Other methods of taking care of nuclear waste include encasing it in glass and putting it deep underground, and also storing it in specially made nuclear waste storage facilities. High level nuclear waste usually takes 40 to 50 years before its radiation levels have gone down to low. The second factor that makes it hard for nations to adopt nuclear power are  dramatic accidents that have occurred in the past due to nuclear power plants. There have been three majors accidents regarding nuclear power in the past with Chernobyl in 1986 , Three -mile island in 1979, and Fukushima in 2011. These three accidents caused much damage to their surrounding ecosystems and caused international shock. The Chernobyl Accident Around 31 years ago, in the soviet state of Ukraine, specifically the city of Chernobyl an accident caused the destruction of the of the Chernobyl 4 reactor. The exact nature of this accident has been a point of argument for many researchers and scientist globally but the most used says that April 25 1986 was a day that was scheduled for testing how long turbines would spin and supply power to the main circulating pumps following a loss of main electrical power supply. It turns out the operator made a series of unsound decisions such as leaving the automatic shutdown mechanisms disabled which left the reactor in an extremely unstable condition. When the operator came back to attempt and enable the mechanisms, the reactor was way too unstable. When the operator began by entering the control rods, it caused a dramatic power surge which led to a series of radioactive explosions which killed 2 workers instantly and a further 28 where killed in the weeks following the explosion. Three – Mile Island Accident In 1979, March 28 was the date of another nuclear accident on the three -mile island in Pennsylvania, United States. It is still largely unknown what exactly happened on that day and much of it is still speculation but the official story says that around 4 a.m. prevented the pumps from pumping water into the steam generators which meant that the cooling system had failed that led to the reactor automatically shutting down and the pressure in the primary system increased and the valve was supposed to contain the pres sure until it had lowered but it got stuck and the operators heard the alarm and thought they should cut off the emergency water supply unaware that the problem was the water being stuck already. Without any water the core overheated. Fukushima Acc ident Following the major earthquake in japan on 2011, a 15 -meter tsunami disabled the power and cooling supply of the Fukushima Daiichi reactors which had been built in the 60s. All three cores largely melted in the first three days. Cost The last reason why nations have a hard time adopting nuclear power is that there is way too much cost that goes with it. A single nuclear power station is $9 billion which is more than 50% of the GDP of many countries around the world not to mention the c osts of upkeep and the level of security needed. Conclusion Nuclear power may be the technology of the future and that is where I say we should leave it because as of now it is not practical for many countries around the globe because of the risks and costs associated with it. We should wait a little before we endeavour on this course. References Backgrounder on the Three Mile Island Accident. (n.d.). Retrieved from https://www.nrc.gov/reading -rm/doc -collections/fact -sheets/3mile -isle.html The Cost of Nuclear Power. (n.d.). Retrieved from https://www.ucsusa.org/nuclear – power/cost -nuclear -power Energy. (n.d.). Retrieved from https://www.merriam -webster.com/dictionary/energy GCSE Bitesize: Radioactive waste. (n.d.). Retrieved from http://www.bbc.co.uk/schools/gcsebitesize/science/ocr_gateway/energy_resources/nu clear_radiationsrev4.shtml Radioactive waste management (n.d.). Retrieved from http://www.world – nuclear.org/information -library/nuclear -fuel -cycle/nuclear -wastes/radioactive -waste – management.aspx Fukushima Accident (n.d.) . Retrieved from http://www.world – nuclear.org/information -library/safety -and -security/safety -of- lants/fukushima – accident.aspx Ch ernobyl Accident (n.d.). Retrieved from http://www.world – nuclear.org/information -library/safety -and -security/safety -of-plants/chernob yl- accident.aspx Marcum, W., ; Spinrad, B. I. (2018, February 07). Nuclear reactor. Retrieved from https://www.britannica.com/technology/nu clear -reactor/History -of -reactor – development#ref307286 Martin, W. (2018, July 05). Nuclear power. Retrieved from https://www.britannica.com/technology/nuclear -power Touran, N. (n.d.). What is Nuclear Energy? Retrieved from https://whatisnuclear.com/nuclear -energy.html    How to cite The Truth About Nuclear Power, Papers

Juliets Confrontation with her Parents Essay Example For Students

Juliets Confrontation with her Parents Essay Juliets Confrontation with her Parents in Act 3 Scene 5 is a Pivotal Scene and Begin the Sequence of Events that lead to the Final Tragedy. Analyse Juliets state of mind here, using evidence from the text as a whole. Provide advice for someone directing Juliet in the extract. This play is a tragedy about two lovers from families with a long history of civil brawls between each other. Act 3 scene 5 is a pivotal scene because from this scene onwards, Juliets life begins to change, as does her emotions and feelings. These changes then lead to the final tragedy where both lovers take their own lives. It is important to look at scenes previous to this one, because you cannot understand what her character is like before this pivotal scene without reading how she has reacted in other situations. It is also important to look at how much her character changes in this scene. Also, without reading the whole text, you will not know the dramatic irony, which Juliet has so often used. In Verona society, men held their daughters in a very firm iron grip. Although men would often go out, women had to stay at home. It would be unheard of to have any form of relationship with a boy if they were not married. Fathers would also give their daughters hand in marriage, and they would never make a fuss about it. Verona women were often married to men sometimes 10 years older than themselves and be having children as soon as they could physically bare children. We first meet Juliet in Act 1 Scene 3. From this scene we can see that Juliet is not close to her mother at all. An example of this is when Lady Capulet says Nurse, give leave a while.Nurse come back again. Lines such as she was weaned, I shall never forget it shows that she is more of a mother to Juliet than her own mother is. The nurse also has pet names for Juliet such as Lamb Ladybird and Pretty fool which shows us that she has obviously got to know what she is like throughout her life. Juliet also has no friends to talk to, and so the nurse has become Juliets best friend. However, the nurse has to do as Juliet and Lord and Lady Capulet say, because she is merely a servant. This gets the nurse into several awkward positions, because although she may think that Paris is more of a match to Juliet than Romeo, the nurse still has to secretly arrange their wedding. This is shown by the quote I am the drudge and toil in your delight Act 2 Scene 5. When Lady Capulet asks Juliet How sta nds your disposition to be married Juliet responds, It is an honour I dream not of. This shows that at the beginning of the play, Juliet is still fairly immature. Although Juliet is only 13 (Come Lammas eve at night shall she be 14) Juliet is now older than Lady Capulet was when she gave birth to Juliet. In Act 1 Scene 5, Juliet and Romeo meet for the very first time. Even as Romeo starts talking to Juliet, he begins using religious language to describe her such as this holy shrine. As Romeo shouldnt even be at the ball, he is very conscience of the fact that they are from rival families. Juliet describes the fact that they are meeting and flirting together as a gentle sin, Juliet uses religious language such as Ay, pilgrim, lips they must use in prayer to tease Romeo as he tries (and later succeeds) to kiss her. This use of religious language shows us that Juliet both understands the concept of religion and believes in it. This religious state of mind is important in Act 3 Scene 5 because when Juliet is asked to marry Paris, although she has already secretly married Romeo. If she went ahead with the marriage to keep the peace she would be committing bigamy, and although no-one else would know, she and God would both know that she was already married. Act 2 Scene two is the infamous balcony scene. As Juliet is talking to herself, we hear her say Deny they father and refuse thy name. Or if thou wilt not, be but sworn my love, and Ill no longer be a Capulet. Juliet says here that she wishes that she wasnt a Capulet, or Romeo wasnt a Montague because she loves Romeo. Here we can see that Juliet knows that she is in the wrong for being in love with Romeo because of the two families quarrels. Juliet also says to Romeo My ears have not yet drunk a hundred words of thy tongues uttering, yet I know the sound. By saying this she is telling Romeo that although he has spoken less than a hundred words to her, she still feels like she knows him. This is important as it shows that Juliet does believe in love at first sight, at least for Romeo. This is important in her state of mind that she feels that she loves Romeo at this point. This is another reason why Juliet wont marry Paris, because she believes that she is in love with Romeo. Juliet goes on to say If they bent of love be honourable, thy purpose marriage, send me words tomorrow She is saying that if Romeos intention of love is honourable he will want to marry her. Juliet is still thinking about how wrong their secret love is, and if they get married, at least God will not see it as such a sin. Juliet is also thinking that if they get married, maybe the two families will unite, as Juliet will become a Montague and her maiden name will be Capulet. From Act 3 Scene 5 everything seems to go on a downwards spiral for Juliet. After Romeo leaves as the sun rises, her mother comes into her bedroom. Here we find Juliet weeping for Romeo, however she uses many double meanings to pretend to Lady Capulet that she is mourning for Tybalts death. Lady Capulet tells her that crying a little shows that she loved Tybalt, but evermore weeping for your cousins death shows some want of wit. To this, Juliet continues to weep and says no man like he doth grieve my heart. Juliets state of mind here is that, although she knows what Lady Capulet is saying, she is truly too distraught about losing her very first love so quickly that she is inconsolable. No matter what her mother says to her, it isnt going to stop her crying. Hatred and selfishness EssayIf I were to direct this scene, I would have Capulet enter from the same large doors as Lady Capulet came through. He has not heard the shouting that has gone on before hand. As he walks in, Juliet is stood up, still with tears running down her face. As he begins to talk to her, he almost mocks how she is crying still for Tybalt, but in a kind, fatherly way that shows understanding. As he says Have you delivered to her our decree he sounds very optimistic about the joys which lie ahead of him. As Capulet gets delivered the bad news, he starts off more confused, and this quickly develops into anger. As he says unworthy as she is he really starts to explode and walks closer and closer towards Juliet. Juliet already has fear, and takes steps backwards as she tries to calm her father down by twisting her words. At this point Capulet must storm forward even more, with Juliet walking backwards and eventually climbing onto her bed. Lady Capulet must try and step in front of Juliet and Capulet, but not so much that either of them are concerned about her presence. After she has told them to stop, Juliet should drop to her knees on her bed. As she begs with Capulet, Juliet should weakly and childishly try to grab Capulet to hold onto, but he has none of it. It is at this point where he gets very violent. He should use his upstage arm to grab her shoulder. As he says the line or never look me in the face he should violently twist Juliets a face to face him. Juliet then must try and pull away from his grip, but he overpowers her. After giving her shoulder a few hard shakes, Capulet then must pick her up and put her over her shoulder. As he delivers the lines such as Out on her, hiding Juliet is dropped to the floor and she lays there, motionless, crying slightly until Capulet exits. After Juliet has found no sympathy in either Lady Capulet or Lord Capulet, Juliet decides that the Nurse might be the one to offer some support, considering that she knows the whole situation she is bound to me more sympathetic. The nurse has also been like a mother and a best friend to Juliet, so she very much doubts that shell disagree with anything that Juliet says. The nurse lays out the situation to Juliet that Romeo is as good as dead so she is best to forget about him. Also, Paris has green eyes, which was considered a great thing in Verona at that time. Juliet is deeply saddened at the fact that the Nurse does not give Juliet the solace she needs. Juliet decides that she can no longer trust the Nurse. This is because she has always supported their secret relationship and helped them to marry and make sure they were never caught. However, the nurse could have only done this because it was an order from Juliet and she could not disobey someone who was higher up than her. Juliet then decides that she can think for herself. For the very first time she lies to the nurse, saying that she is going to confess her sins to Friar Lawrence. She then comments at the end If all else fail, myself have power to die. Juliets love for Romeo has rapidly changed her from a childish first love to being in a mature relationship. Juliet herself has also matured by this stage, as she now has to consider things such as breaking both Gods law and the Civil law to keep the peace between her family. To act out this scene, Juliets performance must be calm, then hurt. As Lord and Lady Capulet leave, Juliet should almost leap into the nurses arms as the nurse sits onto the bed and Juliet gradually gets up from lying where her father threw her down. Although the Nurse should welcome Juliet into a hug, as she gives her opinion on the situation, Juliet should sit further away from the Nurse as she listens to exactly what she doesnt want to hear. As Juliet says, Well, thou has comforted me marvellous much, Juliet should get up and begin to walk towards the door. At this point, Juliet must walk and open the large doors. She should then look over at the nurse and angrily, yet sadly deliver her lines. As she says If all else fail, I have myself the power to die she should stop being so sad and show a very confident side to Juliet. Overall, looking at the text as a whole we can see a dramatic change in Juliet as a person, and her relationship with Romeo throughout the play where we get to the pivotal scene of Act 3 Scene 5. At first we see Juliet as a very young, immature little girl who is having her future planned out for her, showing little sign of trying to disagree. Then we see her begin to take her life into her own hands more, often with the nurses help however, as Romeo and Juliet desperately try and find a way they can both be together. At the end of Act 3 Scene 5 we see that Juliet has become a completely independent young woman, as she goes against the grain of everything people are trying to tell her to do. She also begins to lie to the nurse who she has always trusted before. All these changes in Juliet happen so fast that they almost create the tragic ending themselves.