This reflective essay is centred on pain assessment

This reflective essay is centred on pain assessment For the purpose of the case study I intend to use Gibbs(1998) model of reflection as this model is clear, precise allowing for description, analysis and evaluation of the experience, then prompts the practitioner to formulate an action plan to improve their practice in future(Jasper, 2003). Wilkinson (2007) identifies assessment as the first phase of the nursing process in which a nurse uses their knowledge and skills to express human caring. It is important to choose an organised and systematic approach when caring out an assessment that enhances your ability to discover all the information needed to fully understands someones heath status (Alfaro-Le Fevre,2004) .This can be achieved by obtaining your information form medical record and nursing charts by physical examination of the patient and also talking to patient and their families(Wilkinson,2007). The use of objective data is more helpful in collecting information when the patient is ventilated and sedated, as they are often in the critical care setting, and this can be done by examining the patients vital sign, blood pressure, heart rate, temperature and blood results (Bulman and Schutz 2004). I have chosen pain assessment in post- operative ventilated patient. I have worked in ICU for 4 years during this time I have nursed many post- operative ventilator patients who were on continuous infusion of sedatives and analgesics. Many of them showed signs of inadequate pain relief and associated complications. Having undertaken this module I further educated myself in this field of nursing assessment I now know, or rather have an improved knowledge base and understanding of the different aspects of pain assessment tools and recognize the possibility that I have probably nursed many more patients who were demonstrating symptoms of inadequate analgesia and associated complications. Given an increased awareness and knowledge I have gained through teaching, research and current literature on this topic I now, also recognise the importance of this assessment practice in particular in relation to the ventilated, non- communicated patients in ICU. According to International Association for the Study of Pain (IASP,1979) pain is described as unpleasant sensory and emotional experience associated with actual or potential tissue damage. Clinically pain is whatever the person says he or she is experiencing whenever he or she says it does (Mc Caffery 1979) .Appropriate pain assessment is crucial to pain management. Patients self- report is the gold standard of pain assessment. However pain tools that rely on verbal self-report may not be appropriate for using non- verbal ventilated sedated patients in ICU. Pain assessment tool used in our critical care setting is based on a numerical pain rating score from 0-4, a score of 0 being no pain at all and 4 being the worst pain ever experienced. There is also a visual analogue scale for patients who have difficulty communicating, they can indicate by looking at the chart and pointing at either the happy face that has no pain or a series of faces showing different stages of pain (appendix t hree). These tools were chosen by the specialised pain care nurses working for the trust. The tools are favoured as they provide nurses with a quick, easy assessment. They are used widely throughout the trust to provide continuity of pain assessment.Both of these tools have proved successful in practice and are supported by the literature as being reliable and accurate in practice. However they depend greatly on the patient being able to express themselves or communicate verbally with the practitioner .Using these methods of pain assessment is not accurate on sedated patients with altered conscious level. In nonverbal patients the use of behavioural or physiological indicators are strongly recommended for detection of pain (Jacobi et al 2006). The patient in critical care may experience pain from many sources. Along with physical pain, psychological factors such as fear, anxiety and sleep disturbances may play a significant role in patients overall pain experience (Macintyre and Ready 2002). Urden et al (2010) states, pain can be acute or chronic, sensations are different in relation to its origin. Acute pain-duration is short corresponds to the healing process, ranges between 30 days to 6 months. Chronic pain lasts more than 3 to 6 months and can either or not associated with an illness. Somatic pain is well localised sharp, acute pain arising from skin, muscle, joints. Visceral pain refers to the deep, ill localized arising from an organ. Nociceptive pain occurs when inflammation stimulates pain receptors ( Urden et al 2010). Pain experienced in critical care patients are mostly acute and has multiple origins. Mr. Smith a 45 year old gentleman admitted to ICU following Laparotomy for small bowel perforation and faecal peritonitis. Mr Smith was cardiovascularly unstable and was unable to be extubated immediately after surgery due to secondary sepsis. He was receiving an infusion of Propofol and Fentanyl to keep him comfortable and provide analgesia. His medical notes revealed his past medical history of previous Cholecystectomy for gall bladder stones and biliary obstruction. I was assigned to nurse him on his second day in ICU. During handover the previous staff member reported that Mr. Smith became very agitated and hypertensive soon after he was repositioned to his side. Mr. Smith was given a bolus dose of Propofol infusion and the rate of Infusion increased. Whilst doing the Patient assessment I noticed Mr Smith is restless and not compliant with the ventilator. Arterial Blood Gas (ABG) performed which showed Mr. Smith is hypo ventilating. Meanwhile Mr. Smith became more agitated with e scalating non-compliance with ventilator and significant increase in his Mean Arterial Pressure (MAP) which was being monitored continuously by the arterial line and transducer. He was showing facial grimaces and moving his extremities restlessly. I tried to reassure him by talking to him, reorientating him to time, place and person, explaining to him that he is safe. Adam and Osbourne (2005) identifies that critically ill patients frequently require help with coping with many of the stresses like physical discomfort, isolation, fear of pain and death. By using strategies like communicate caring and understanding and provide information repeatedly and in sufficient detail for the patient etc. helps the patient to cope with the stress. But repeated reassurance and reorienting has not made any improvements in his current status. Pain is an important problem in critical care and its detection is a priority. Pain assessment is vital to detect pain (Urden 2010). Pooler-Lunse and Price(1992) emphasises that critically ill patients who are unable to communicate effectively are at high risk of suffering from pain. Poorly controlled pain can stress the sympathetic nervous system leaving vulnerable patients at risk of complication and can compromise recovery and negatively affect both morbidity and mortality(Puntillo et al 2004, Dracup and Bryan- Brown 1995).Mr Smith was ventilated and due to the effect of sedatives his level of consciousness was altered. In critical care factors alter verbal communication is mechanical ventilation, administration of sedative agents and the patients change in level of consciousness (Hamill-Ruth R J, Marohn L 1999 ,Kwekkeboom K L, Herr K 2001,Shannon K, Bucknall T 2003). The consequences of untreated acute pain in critically ill patients include increases in catecholamine and stress hormone levels which are potential causes of tachycardia, hypertension, increased oxygen requirements and decreased tissue perfusion (Blakely and Page 2001, Hamill-Ruth and Marohn 1991). Mr Smith was increasingly hypertensive and tachycardia. Despite giving increased oxygenation Mr.Smith was hypo ventilating due to non- compliance to the ventilator. Marshall and Soucy(2003) identifies agitation is a common problem in critically ill patients and has been shown to be associated with inadequate pain management. Agitation can have serious consequences with patience removing access lines compromising their oxygen needs by self extubating (Cohen et al 2002). Following discussion with the nurse in charge of the shift it was apparent that Mr. Smith was showing behavioural signs of pain. There were no other obvious reasons as to why he had become compromised with his ventilation.When I approached the medical team concerning Mr.Smiths increasing agitation and non- compliance to ventilation I was instructed to give a bolus of propofol and fentanyl and to increase the rate of propofol and fentanyl until Mr Smith was deemed medically manageable. I was decided to increase Mr.Smiths ventilatory support. Following the treatment Mr Smith became much more stable, he became less tachypoenic was synchronising with the ventilator; his blood pressure was within acceptable limits and monitoring in sinus rhythm. The clinician did not assess Mr Smith for signs of inadequate pain management. Unfortunately due to hypoventilation and non-compliance to mechanical ventilation, Mr Smith had to be remained on high levels of ventilation and increased levels of sedatives for the next few hours emphasising evidence by Pooler-Lunse and Price(1992), the physiological complications associated with pain including Pulmonary complications and increased cardiac workload as well as depression and anxiety and increased days of hospital stay(Desbians et al 1996).Upon further reflection I should have noted Mr Smiths agitation associated with inadequate pain relief. Had I been knowledgeable in this field Mr.Smiths agitation and physiological signs of restlessness and facial grimaces would have prompted me to carry out a detailed pain assessment. Had there been a behavioural pain assessment scale on the unit where I work that may have prompted me carry out the assessment and linked these signs as indicators of inad equate pain relief. During my further assessment of Mr.Smith I had various thoughts and feelings which included feeling apprehensive and self-doubt regarding the decision to increase sedation and ventilator support. Whilst reviewing his past medication history I noticed that Mr Smith had been on regular analgesics which are co-codomol and paracetamol and there was no indication for their use in his notes. Fink R (2000) recognises that reviewing patients past pain experiences and how did he or she usually react to it can be of good value when assessing pain and can help to decide treatment options ,by questioning patients family or significant other can provide us the information about patients pain history. Later during the visiting hours Mrs Smith came to visit Mr Smith. I have given her a brief update of his condition including the changes made to his sedation and ventilation. Then I enquired to Mrs Smith about the indication of those analgesics he was on .She revealed that Mr.Smith developed back pai n when he discharged to home after undergone cholecystectomy six months ago and he was prescribed those analgesics by his G.P(General Practitioner). She also mentioned that he had problems getting optimal pain relief post operatively even when he had cholecystectomy, and he would not tolerate lying on his sides. This co-related his agitation and restlessness happened when the night staff turned him to his side. I notified these things to the ICU doctors and raised my concern that lack of adequate pain management could be the reason for Mr Smiths earlier agitation. They also agreed on this possibility and advised to change fentanyl infusion to remifentanyl and to adjust the rate of the infusion to keep Mr Smiths pain relief optimal. Remifentanyl is potent analgesics, so ensure the patient is pain free but prevents over sedating the patient, allows rapid arousal and recovery from sedation thus facilitates daily sedation holds and neurological assessment( Dhaba et al 2004). He was also prescribed regular paracetamol and Tramadol when required. It was then decided to reduce Mr.Smiths sedation as he was haemodynamically stable, he was then able to respond and started following commands. Mr. Smith was now able to communicate if he had pain or not by squeezing my hand to command. Invasive technology can restrict the reliance on many behavioural indicators of pain (Bucknall and Shannon 2003) on the other hand it is argued that invasive lines enables constant monitoring of blood pressure (B.P) and heart rate (H.R), two commonly utilised indicators of pain and thus help to assess pain (Bucknall and Shannon 2003) .Even though Mr Smith was hypertensive and tachycardic this was presumed to be due to agitation. In a contradicting statement Bucknall and Shannon(2003) points out that the sympathetic symptoms i.e. Increasing B.P and H.R are also been found to be unreliable. Pooler-Lunse and Price (1992) emphasises that the Para sympathetic stimulation can result in less observable signs with prolonged pain, but pain intensity remains unchanged. The American Society for Pain Management Nursing (ASPMN) recommendations cited in Herr k et al ( 2002) emphasises that vital signs can be affected by other distress conditions, homeostatic changes and medications there for they should not be considered as primary indicators of pain.With conflicting evidence it is difficult to make decisions that best support this assessment practice. Anand K J S,Craig K (1996), Herr K et al (2006) states that behavioural indicators are strongly recommended for pain assessment in non- verbal patients , few tools have been developed and tested in critically ill patients. The Behavioural Pain Scale (BPS) and the Critical Care Pain Observation Tool (CPOT) are suggested and supported by experts for using uncommunicative critically ill patients (Li-D, Puntillo, Sessler 2008). BPS was tested and validated exclusively in ventilated, unconscious patients (Payen et al 2001,Young G 2006, Aissaoui Y et al 2005).The Behavioural Pain Scale (BPS) includes three behaviours 1) facial expression 2)movements of upper limbs3)compliance with the ventilator. Each behaviour is rated on a scale from 1 to 4 for a possible total score from 3 to 12. The BPS can be used quickly (2 to 5 minutes), most clinicians were satisfied with its ease of use (Payen et al 2001). The Critical Care Pain Observation Tool (CPOT) was tested in verbal and non- verbal critical ly ill adults (Gelinas C 2006,2007) its content validity supported by ICU experts including nurses and physicians (Gelinas C 2009). CPOT includes four behaviours 1) facial expression 2) body movements 3) compliance with the ventilator 4) muscle tension. Each behaviour is rated from 0 to 2 for a possible score of 0 to 8.Gelinas C and Hammond reports that feasibility and clinical utility of CPOT were positively evaluated by ICU nurses and agree it is easy to complete, simplicity to understand the usefulness for nursing practice. My experience of using a behavioural pain scale tool is limited, however I feel that if practitioners were able to assess pain more accurately then they would be able to manage there patients pain more effectively. Use of a behavioural pain score (BPS) evaluating facial expressions, limb movement and compliance with the ventilator has proved to be a valid reliable tool in practice. A recent study evaluating the reliability and use of the BPS consistently identified increases in pain scores after repositioning patients in the ICU. There were only small non- specific changes in the BPS after non painful intervention of eye care (Gelinas etal 2006). I nursed Mr Smith again 5 days later. He had since been extubated and was alert and oriented. Even though he could not remember the events when he was ventilated and sedated, he learned from his wife what had happened. He was very thankful to me for investigating the possible reason for his agitated behaviour and prompting the doctors about this and thus provide him adequate pain relief. Upon further reflection and evaluation of my assessment of Mr.Smith I feel there have been positive and negative aspects of the assessment. The positive aspects include- I have been able to gain further knowledge in various aspects and tools of pain assessment .By reviewing patients medical notes and gaining history from his wife I have linked his agitated behaviour and taken the possibility that these are signs of inadequate pain relief and I have managed to convince the medical team regarding this in order to act on it. Current research identifies multidisciplinary collaboration provides optimum care for the patient (Bucknall T, Shannon K 2003), this emphasises the need to perform regular, accurate pain assessment and care full documentation (Bucknall T, Shannon K 2003). When considering the negative aspects of my assessment I feel I did not use a holistic approach instead I considered Mr.Smiths agitated behaviour as a physical problem, I was concentrated to treat the symptoms and not the patient. As described in Roper Tinney L(1989) assessment tools achieving patient centred nursing is important. I could not identify Mr.Smiths behavioural indicators of pain primarily due to my lack of knowledge about this assessment tool as well as there was no unit assessment protocol which includes the behavioural assessment scale, Unfortunately this is not isolated, it is in fact a universal problem .Camp (1998) points out that like many speciality nurse critical care nurses and physicians recognises that there basics education was insufficient for caring for patients in pain. Accurate detection of the critically ill patients pain is not an easy task for ICU nurses especially when the patient is unable to self-report because of mechanical ventilation or due to the effects of sedatives. Stanton (1991) argues that pain assessment and management may be significantly improved by enhancing nurses knowledge combined with improved communication of the problem. NMC(2008)emphasises that having appropriate knowledge, skills and attitude towards pain, pain assessment and its management is essential to provide optimum patient care. Use of pain assessment tools is highly recommended by Kaiser(1992), identifies that an effective pain assessment tool as part of the documentation improves communication between patients and nurses as well as nurses and medical staff. Even though we had a pain assessment tool (0 to 4 numeric pain assessment scale) due its limitations on the use in non-communicative patients it was not contributing much in patients pain management. The previous practitioner documented the patients pain score is Unable to assess as the patient is sedated and ventilated. This highlights the inappropriate use of our pain tool currently being used in practice as a patient is unable to verbalise or communicate their pain if they are sedated and ventilated. Although todays guidelines strongly suggest that the use of a standardised behavioural pain scale to nurses who care for uncommunicative patients, further research is still needed to fully understand the behavioural and physiological responses of critica lly ill patients who are experiencing pain (Herr K et al 2008). On reflection my underpinning knowledge and confidence in this area of assessment has developed tremendously. I feel that I have gained knowledge and insight into an important patient assessment, from an initial lack of sufficient knowledge I am now able to bring evidence based practice in the clinical area which will benefit the patient and my colleagues. By understanding the physiology, pain assessment tools and the complications of poorly managed pain, I will have the knowledge and skills to manage these patients. The use of sedatives and analgesics places a great deal of responsibility on critical care nurses and they must understand how the drugs work , complications of their use and how to monitor effectiveness staff must understand sedation does not equate analgesia (Ashley and Given 2003). The use of an appropriate pain assessment tool and management algorithm is essential for adequate pain management. Since undertaking this study, it is of interest to note that our practice development nurse and the specialist pain nurse for ICU ,have jointly developed a behavioural pain assessment scale similar to the BPS and CPOT scale, and staffs are encouraged to use it routinely. I feel that my action plan and recommendations are to promote the use of the pain assessment tool by educating the nurses and emphasising the importance of this assessment to improve patient outcome. The need for education to train staff on how to use the tool would take both time and money. The NHS is already under extreme financial pressures and money for training is not readily available. However if an improvement in pain management was successful then patients stay may be shorter, thus having a beneficial effect. I am also aware of the importance of not relying solely on the assessment tools but the use of both good nursing assessment and assessment tools to improve optimal patient management, shortening the recovery time and reducing the likely hood of complications (Ashley and Given 2003). A sedated, ventilated, non-communicative patient is vulnerable and relies completely on those providing care for them but as to their family at this anxious time. Education and training will improve patient care and ultimately patient safety which is paramount. Therefore I will take the knowledge and information I have acquired back to my clinical area as I have a duty to provide a high standard of practise and care at all times (NMC 2008)

Analysis of Bulgaria :: Essays Papers

External historical events often changed Bulgaria's national boundaries in its first century of existence, natural terrain features defined most boundaries after 1944, and no significant group of people suffered serious economic hardship because of border delineation. Postwar Bulgaria contained a large percentage of the ethnic Bulgarian people, although numerous migrations into and out of Bulgaria occurred at various times. None of the country's borders was officially disputed in 1991, although nationalist Bulgarians continued to claim that Bulgaria's share of Macedonia--which it shared with both Yugoslavia and Greece--was less than just because of the ethnic connection between Macedonians and Bulgarians. In 1991 Bulgaria had a total border of about 2,264 kilometers. Rivers accounted for about 680 kilometers and the Black Seacoast for 400 kilometers. Ridges in mainly defined the southern and western borders high terrain. The western and northern boundaries were shared with Yugoslavia and Romania, respectively, and the Black Sea coastline constituted the entire eastern border. The Romanian border followed the Danube River for 464 kilometers from the northwestern corner of the country to the city of Silistra and then cut to the east-southeast for 136 kilometers across the northeastern province of Varna. The Danube, with steep bluffs on the Bulgarian side and a wide area of swamps and marshes on the Romanian side, was one of the most effective rivers boundaries in Europe. The line through Dobruja was arbitrary and was redrawn several times according to international treaties. In that process, most inhabitants with strong national preferences resettled in the country of their choice. Borders to the south were with Greece and Turkey. The border with Greece was 491 kilometers long, and the Turkish border was 240 kilometers long. Bulgaria covers approximately 110,550 square kilometers. Its topography is mostly hills combined with plateaus, with major flatlands to the north and the center of the country. Its main mountain ranges Balkan and Rhodope include two major ranges, Pirin and Rila. The climate is divided by mountains into continental and Mediterranean. The rainfall is very variable, with largest amounts in higher elevations. Its population estimate is 8,989,172. Its 1990 growth rate was negative .35 percent, and its population density eighty-one per square kilometer. Bulgaria’s official state language is Bulgarian. There is also a main national minority language witch is Turkish. Bulgaria has many different ethnic groups. The country is made up of 85% Bulgarians, 8.5% Turks, 2.5% Gypsies, 2.5% Macedonians, 0.

Oxalate ION Essay

The dissociation of protons from oxalic acid proceeds in a stepwise manner as for other polyprotic acids. Loss of a single proton results in the monovalent hydrogenoxalate anion HC2O4−. A salt with this anion is sometimes called an acid oxalate, monobasic oxalate, or hydrogen oxalate. The equilibrium constant (Ka) for loss of the first proton is 5.37Ãâ€"10−2 (pKa = 1.27). The loss of the second proton, which yields the oxalate ion has an equilibrium constant of 5.25Ãâ€"10−5 (pKa = 4.28). These values imply that, in solutions with neutral pH, there is no oxalic acid, and only trace amounts of hydrogen oxalate.[1] The literature is often unclear on the distinction between H2C2O4, HC2O4-, and C2O42-, and the collection of species is referred to oxalic acid. otany patnawomenscollege.in/journal Explore, 2010, Page No. 63–67 Vol. II No. 2 Analysis of oxalate of fresh and stored tomato juice Devshikha*, Nitya Priyadarshi*, Sukriti Rani Prasad** *B.Sc. –II year (2008-2011), Department of Botany, Patna Women’s College, Patna University **Lecturer (Gue Premium663 Words3 Pages Study of Oxalate Ion St. John’s Senior Secondary School and Junior College Mandaveli Chennai – 600028 A CHEMISTRY PROJECT â€Å"STUDY OF THE OXALATE ION CONTENT IN GUAVA FRUIT† Submitted in the partial Fulfilment of the requirement for AISSCE 2010-2011 By Abdud Dayan Adeeb Of Class XII C St. John’s Senior Premium1368 Words6 Pages Oxalate Oxalate From Wikipedia, the free encyclopedia Jump to: navigation, search The structure of the oxalate anion A ball-and stick model of oxalate Oxalate (IUPAC: ethanedioate) is the dianion with the formula C2O42−, also written (COO)22−. Either name is often used for derivatives, such as

Racial Prejudice

Racial Prejudice It Is human nature to want to feel accepted. Prejudice In the United States, specifically with Immigration has been a major Issue. Julie Toasts describes this prejudice in â€Å"Evacuation Order #1 9† which is about a Japanese-American family and the internment camps that affect them during World War II. However, prejudice is not only found in the United States. Marine Satraps writes about her experience as an Iranian during the Iranian Revolution of 1979 and her refuge in Austria to finish high school In the graphic novel â€Å"The Vegetable†.While â€Å"Evacuation Order #19† Is about exclusion and â€Å"The Vegetable† Is about acceptance, they both deal with the pre]delude associated with Immigration. It Is hard to compare apples and oranges, just as it is hard to compare a short story and a graphic novel. Regardless of the style of writing, the point of writing is to convey a message to the reader. Both do a pretty good job of showing t he difficulties of living in a foreign country, but Toasts describes the exclusion associated with immigration in a more powerful way.Evacuation Order #19†³ by Julie Toasts is about a Japanese-American family living In California In the spring of 1942. After the Japanese bombed Pearl Harbor In December of 1 941 , rumors began spreading around the united States that Japanese- Americans were going to sabotage military efforts. President Roosevelt issued an order that would imprison nearly 120,000 people with Japanese ancestry. The characters in â€Å"Evacuation Order #19† are being affected by this order. The family had assimilated into the community before President Roosevelt issued the order.We understand that the mother has a friendly relationship with the store owner Joe Lund. Melee Glasses,' Joe Lund said the moment she walked through the door† (Toasts 381 This shows that the family assimilated Into the local society because the shop owner comments on something new he sees with her. Joe Lund even offers that the mother does not have to pay for the items she purchased from the store. The reader is led to infer that the family has been a part of the community for a long time and they are nice people that wouldn't do anything to harm the country.As the story concludes, we see that the family is being taken to â€Å"wherever It was they had to SGF' because of their race and the family cannot do anything about It. The exclusion that is imminent on the family is a direct result of racial prejudice. â€Å"The Vegetable† by Mar]Anne Satraps takes place in the late asses or early 1 sass in Vienna, Austria and is about her own life. Marine Is Iranian and living without her parents as she attends school in Austria. During the late ass, Iran was going through a large scale political and social revolution.The revolution became violent in many tuitions, In fact in January of 1978 students began to protest and many students died during the protes t. As a reader of â€Å"The Vegetable† we don't know the nationality of Marine until page 482 when she sees stories about Iran on the TV and she talks about her attempts to â€Å"make her past disappear† (Satraps 482). We do not really see her being excluded or treated differently because of her nationality by the other students. It seems that she does not accept herself as she is constantly changing the way she looks and that she smokes marijuana with some of the other students.As and makes the comment about trying to disappear. In the end when she proclaims she finally relinquished the prejudice that she put on herself. The exclusion Marine feels is because of her race but also because she put herself into a situation where she feels excluded. Both stories show that the characters are capable of assimilating into the new culture and by the end the stories, racial prejudice has an effect on their lives. Evacuation Order #19†³ shows very clearly that the character s are being excluded based on racial prejudice where The Vegetable† implies that part of the exclusion is because of other factors, and not necessarily her race. The reader develops a stronger emotional feel for Tossup's characters because you feel bad for the situation they are in. To truly understand how a character is feeling, one would have to look at the choices or decisions that the character makes. The characters in these two stories both feel excluded, and the actions that they decide to take, show the extent of the racial prejudice.Julie Toasts writes about a mother who spends the entire day caking her house before her family and she are taken away. The degree of racial prejudice that she felt caused her to have a very emotional day. Not only did she pack away all of her belongings, she had to put down their dog, release their bird and hide sentimental objects and after hiding her emotions as to not scare her children, she finally has one last moment in her home to re flect on her emotions. â€Å"†¦ And began to laugh – quietly at first, but soon her shoulders were heaving and she was gasping for breath.She put down the bottle and waited for the laughter to stop but it would to, it kept on coming until finally the tears were running down her cheeks† (Toasts 386). Her emotions took over and she lost control because of the racial prejudice and what it made her do. Marine in â€Å"The Vegetable† felt such a strong exclusion from her racial prejudice that she decides to lie about her nationality to a stranger at a party. She wanted to disappear from her past because she was tired of being Judged based on where she is from. After Marine proclaims that she is proud to be Iranian, she starts crying. But really, I had nothing to cry about. I had Just redeemed myself. For the first time in years, I felt proud† (Satraps 485). She felt so relieved that the weight of racial prejudice was no longer affecting her and she began t o feel more comfortable. The actions that the characters perform in these stories show the power that racial prejudice put on them. The mother's actions in â€Å"Evacuation Order #19† are a bit more extreme than Manner's actions in â€Å"The Vegetable† and because the actions are more extreme, the reader can't help but feel more empowered by Tossup's story.While both Julie Tossup's â€Å"Evacuation Order #19† and Marine Satrap's â€Å"The Vegetable† have powerful effects on the reader, Toasts writes a more powerful story. She effectively shows the exclusion caused by racial prejudice and the effect it had on families during this time. â€Å"The Vegetable† has a confusing message because we are not sure if the stress she feels is from racial prejudice or if it is because of a teenagers desperate desire to feel included where â€Å"Evacuation Order #19† has a very clear and strong message of racial prejudice that makes the reader feel for them more.

Utilizing Rubble From Demolition Of Buildings Construction Essay

The devastation of 1000s of edifices during World War II gave the people inquiries about what to make with the debris. It wasn t until the 70 s that the potency of rubble to be recycled was explored. Today, concrete is the most widely used edifice stuff in the universe. We use it for our houses, roads, edifices, Bridgess, and most of our constructions around the universe. Concrete after it s used, is sent straight to be disposed of in our landfills. With a batch of attending traveling into the health of our environment, we recycle points such as paper and plastics, to cut down our impact on the environment. We believe that by recycling concrete, non merely will our impact on the environment be reduced, but its economical advantages are adequate ground to recycle concrete. The intent of this paper is to educate ourselves and the reader about what we can make to cut down our impact on the environment by using rubble from destruction of edifices. Environmental Impact hypertext transfer protocol: //www.torontoenvironment.org/gravel/impacts To pull out virgin sums, we have to delve open-pit mines. The sums are so blasted out or delve out. The most common effects are dust, pollution, noise, deposit. The physical alteration to the environing land causes the most impact. All the flora must be removed doing a loss of wildlife and biodiversity. Improper technology leads to improper drainage which causes eroding. In some instances, H2O used to rinse the sums seep into the land and contaminate land H2O. After a prey is used, it is rehabilitated to be restored to its former status. A survey was done in Ontario and less than half of the land disturbed for aggregative production between 1992 and 2001 has really been rehabilitated. By utilizing recycled sums, we can cut down the demand to mine sums. We can utilize the energy that would otherwise be used for excavation, transporting, and processing, to recycle used concrete from dismantled constructions. Recycling concrete is a great alternate to disposing concrete. The usage of recycled concrete reduces the waste that would otherwise be dumped into landfills. The sum of solid wastes at a municipal landfill is comprised of 23 – 33 % of waste from destruction of edifices. Landfills don t acquire smaller. They will increase in size and cut down land that could be used for residential and commercial utilizations. Economicss of Recycled Concrete Concrete is the most widely used edifice stuff in the universe. Because we are extremely dependent on Concrete is cheaper to recycle than sent to landfills but there are restrictions on economic nest eggs. Location is a large factor when looking at the costs of recycling concrete. Typically, remote countries have really small to no entree to recycling sites raising transit costs. During our research, we found that there is a bound where the cost of haling to a recycling works exceeds the cost of dumping in a local landfill. Here in Lethbridge for illustration, it costs $ 22.25 per metric ton to dispose concrete debris in landfills. The nearest recycling works is in Calgary and would be 100s of dollars to transport the debris. Mobile concrete crushers can be used to recycle but they should merely be used on big undertakings. Portable crushers are non widely available in all parts of the state. In some instances, rental and labour costs would transcend dumping costs. Average trucking cost is $ 0.13/ton/km. Processing costs for the recycler costs between $ 2.76 and $ 6.61 per metric ton. The larger the works, the more efficient and more end product it produces. RCA merchandises sell for between $ 1 and $ 18 per cubic metre, with the higher terminal being in aggregate-poor countries. Natural aggregates usually sell for about $ 8. A large advantage of recycling is that you can bear down disposal fees to companies that want to dispose their concrete debris. The works can order the cost of this fee and compensate for the lower recycled sum monetary values. On the other manus, the cost of recycled concrete depends on market monetary values of virgin sums. Natural sums dominate the markets therefore they dictate the monetary values of RCA. Get downing a concrete recycling concern will necessitate an investing of $ 4.40 to $ 8.80 per metric ton of one-year capacity. USGS ( U.S. Geological Survey ) has done a thorough analysis on the costs of different sizes of recycling workss: Based on their research, a large factor that affects the feasibleness of get downing a recycling works depends on the sum of rubble that can be recycled. When a works is non runing near full capacity, the profitableness of the works reduces. It was found that little recycling workss will hold a tougher clip doing net incomes. Small workss are to a great extent affected by the altering market conditions. But they can increase tipping fees or increase merchandise monetary value to counterbalance for the little net incomes. But in most instances, merchandise pricing is out of control of the manufacturer. On the other manus, medium and big recycling workss are more profitable. Larger operations have lower operating costs ( table 4 ) and do non necessitate a tipping fee to hold a rate of return of 12 % . Uses About all edifices today are partially made of concrete. A large portion of recycling is what the stuff can be used for. There would be no point of recycling if there was no usage for the terminal merchandise. The most common manner of utilizing sum is utilizing it as a bed under roads called a bomber base. The crushed concrete provides extra strength to the foundation of the roadway. RCA can besides be used as pipe bedclothes for belowground public-service corporations such as sewerage and storm pipes. The RCA provides a stable foundation to put the pipes on. A job with utilizing RCA for structural class concrete is that the denseness of the aggregative depends on the denseness of the original concrete. In some instances, the denseness of howitzer reduces the strength of the sum. Typically, a mix of natural sums and recycled sums are used when RCA is used in structural class concrete. It was found that up to 20 % of RCA can be used before the compressive strength of the concrete is reduced. Before it is used in structural class concrete, it should be tested and it should run into certain specifications set by ASTM. Concrete made from RCA is typically used for low-rise edifices but its usage in big edifices is really limited. Recycled concrete is being used for kerb, acmes, pavements, and troughs. The decreased specifications allow the RCA-concrete to be used in constructions that don t require defying heavy tonss. Recycled concrete doesn t needfully hold to be used as an sum. Rubble can and has been reused for other intents in its natural province. Recycled concrete is comparatively inexpensive and abundant which makes it perfect for landscaping. Slabs of concrete can be shaped and used as pavers, while larger pieces can be stacked and laid with howitzer to be used as a retaining wall. Large pieces can besides be used as riprap. The riprap acts as a barrier and absorbs impact from moving ridges to cut down eroding along shorelines. It can protect constructions from harm where H2O eroding is a job. Noise barriers can be built in residential countries along main roads. The noise barrier can be built with RCA or it can be built similar to retaining walls to do it aesthetic. Reasons to Recycle Natural sums are unlimited. So why should we recycle? States like here in Canada have tremendous sums of natural resources. We will ne'er utilize all our resources but the distribution of resources around the universe is different. States like Japan have really limited sums of land. They rely to a great extent on importing natural stuffs. Location is a large factor. Preies can non be built anyplace. They have to be carefully planned and approved by the authorities before they can be built. Remote countries frequently have really small to no entree to raw stuffs so it s more executable to utilize what s already available. With increasing attending towards planetary heating authoritiess are puting ordinances to cut down CO2 emanations. Companies are under a batch of force per unit area to cut down those emanations. Recycling concrete allows us to avoid transit of stuffs which leads to less ingestion of fossil fuels. Recycled concrete has a C footmark 65 % less than tantamount merchandises from quarried rock. ( RMIT Life Cycle Analysis ) . If your company aims to cut down its environmental impact, recycling concrete is a great option. Companies are afraid that utilizing recycled sums will cut down the qualities of their merchandises. Recycling concrete is a reasonably new engineering so companies are disbelieving of its hereafter. When the word recycled is mentioned, it is assumed that the quality is reduced but that is non needfully true. Several research organisations have concluded that with proper mixtures, RCA can surpass natural sums in some ways. Another ground to recycle is because of market conditions. Landfill infinite is going scarce and municipal authoritiess are increasing landfill dumping costs. Recycling allows us to extinguish the landfill cost. In instances where portable workss are used, haling costs are besides eliminated. So non merely are you potentially salvaging money, you are besides cut downing the concrete that goes to landfills. Barriers hypertext transfer protocol: //www.pwri.go.jp/eng/activity/pdf/reports/kawano01.pdf As mentioned before, recycling concrete is new to the industry. Most companies have non been exposed to the new engineering and are still loath to give it a opportunity. It is a known fact that RCA has a lower quality than virgin sums. The quality varies from site to site. You will necessitate a batch of quality control proving to guarantee that the RCA will non cut down the quality of the concrete. This discrepancy in quality does present concerns about the quality of constructions being made. Most companies merely lack the experience with recycling and recycled merchandises. When new building methods are introduced, sufficient cognition is required to accomplish a high quality terminal merchandise. Future of recycling concrete We believe that recycling concrete is the hereafter of the industry. As clip goes, more people will be exposed to this engineering. The benefits far outweigh the disadvantages. It will be widely accepted in the hereafter whether its 5 old ages from now or 20 old ages from now. The procedure When edifices are demolished, much of the left over stuffs are comprised of concrete, wood, and rebar. The procedure begins after the edifice has been demolished. The reclaimable stuffs are trucked to the recycling works or a portable crusher is brought into the site. The chief equipment used is a crusher. The debris is fed into the crusher and the fragments of concrete are crushed into little pieces. The crushed pieces are put on a conveyer belt where it leads to a magnet. The magnet picks up the reinforcing from the crushed stuffs and separates it into its ain heap. Other stuffs such as wood are by and large removed by manus. The merchandise from the magnet is so screened and separated into separate sizes. The crushed debris goes through a screen mesh where desired sizes can fall through while larger pieces can be isolated. Depending on the specifications of sum required, the larger pieces can be sent to a secondary crusher where it can be crushed farther. The crushed pieces are separated into their ain hemorrhoids harmonizing to size. They are stockpiled until they are sold. There are multiple types of crushers to see: * Jaw Crushers comprised of two jaws ; one stationary and one moving. As the concrete moves down the home bases, the concrete is crushed into smaller pieces. The spacing between the undersides of the home bases ensures that merely little pieces make it through. The merchandise ranges between 4 -8 in diameter. These types of crushers can be used as a primary or a secondary crusher. * Impact Crushers Spinning rotors with bars or cocks fling the concrete into a solid home base doing the concrete to disintegrate into smaller pieces. The terminal merchandise is a 2 sum. These types of crushers can be used as a primary or a secondary crusher. * Cone Crushers – Concrete is crushed between two cone shaped home bases. Cone crushers can manage pieces no larger than 8 which makes it suited as a secondary crusher. The location of the undertaking affects the type of recycling workss to be considered. * Stationary workss These are the same as the aggregative workss we see today. They are fixed to one topographic point. The stuff is trucked into the works. Because they are stationary, they have no restrictions on the size of the operations. * Portable Recycling Plants These are by and large put on a human body and towed to the site. It remains stationary on site until it is moved to another location. * Mobile Recycling Plant These are towed to the site like portable recycling workss but they have paths which allow them to travel around the site. The type of works used should be based on the sum of stuff to be recycled and it s location from the nearest works. Stationary workss are more efficient at recycling big sums of concrete due to larger size of operation. Portable and nomadic recycling workss should merely be considered where there is a big distance between the site and the nearest recycling works. Features of Recycled Aggregate Concrete For the mixture design the same procedure is followed as if you would utilize virgin sum. You would hold to travel through test mixtures to acquire the right proportions and to look into the concrete quality. Excess attending should be made on the higher soaking up rate of the recycled sums, which influence would act upon the batch mixture. Blending H2O and workability Because of the high soaking up of the recycled sums more mixing H2O and a higher get downing slack may be needed. Recycled sums absorb H2O even after blending, so to antagonize this, the sum should be pre-wetted in their stock hemorrhoids. Water-cement ratio When get downing it may be assumed that the compressive strength is the same for if you would utilize virgin sum as recycled concrete sum. The recycled concrete should incorporate both class sum and natural sand and the water-cement ratio should be adjusted consequently if the compressive strength is lower than idea at first. Cement content Compared to conventional concrete, in recycled aggregative concrete there should be higher cement content because of the higher fee H2O demands for the recycled sum. Excess 5 % cement would be required when harsh sum and virgin mulcts are used, and an excess 15 % if both coarse and mulct recycled sums are used. Density and air content New concrete will hold a lower denseness runing from 5 % to 15 % . The natural air content might be a small higher so conventional concrete and an air-entraining alloy is added if freeze-thaw lastingness is required. Compressive Resistance The compressive opposition of recycled aggregate-concrete will be lower than that of concrete utilizing natural sums. A survey done by ECCO ( Environmental Council of Concrete Organizations ) concludes that recycled aggregative concrete will hold a 5 % -10 % decrease of compressive opposition. Features of Recycled Concrete Aggregate Gradation When the concrete debris is crushed, the produced sums are screened harmonizing to size. They are so separated to desired step. Like natural sums, they are separated into all right sums or coarse sums. Particle Shape and Size Recycled coarse sum is similar in atom form as crushed rock or natural sums. Fine and coarse sums are more angular which gives them a higher soaking up which lowers the workability of concrete. The sum of all right atoms ( & A ; lt ; 4.75mm in diameter ) is estimated to be 5-20 % of the entire volume of the RCA. Specific Gravity and Absorption The specific gravitation of RCA is much lower compared to natural sums. This is due to the cement and howitzer that held the old concrete together before it was crushed. The SG of RCA ranges from 2.35 to 2.38. The specific gravitation additions as atom size as class atom size lessenings. Te specific gravitation greatly decreases as atom size lessenings. The porous nature of howitzer and cement allows for higher soaking up within the recycled sum. Coarse Aggregates by and large absorb 2 % -6 % of H2O of its volume while all right sums by and large absorb 4 % -8 % of their volume of H2O. Density The majority denseness of recycled concrete is by and large lower than natural sums due to the lower denseness of the howitzer. The denseness of harsh RCA is around 2430 kg/m The denseness of all right RCA is 2310 kg/m Coarse virgin sums have a denseness of 2700 kg/m. Coarse virgin sums have a denseness of 2590 kg/m. The denseness of RCA will change depending on the water/cement ratio and the type of concrete used in the original concrete mixture. Decision The ratio of denseness of the stuff to the denseness of H2O at a specified temperature is defined as the specific gravitation of a stuff. Compressive Strength of original concrete and recycled sum concrete for assorted water/cement and coarse/fine aggregate ratios

Characteristics of civilized societies and civilization Assignment

Characteristics of civilized societies and civilization - Assignment Example â€Å"A Labyrinth that housed the Minotaur, a monstrous creature, half man and half bull, the product of the union of Minos’s wife Pasiphae with a bull. Minos exacted from Athens a regular tribute of seven boys and seven girls, who was sent to be devoured by the Minotaur. The Athenian hero Theseus volunteered to stop the grisly tribute. He went to Knossos with the new group of intended victims and, with the help of the king’s daughter Ariadne, killed the Minotaur in its lair in the middle of the Labyrinth. He then escaped with Ariadne and the Athenian boys and girls. Theseus later abandoned Ariadne on the island of Naxos, but the god Dionysus discovered her there and comforted her† (Cunningham and Reich).What aspect of the first chapter most intrigued you?The civilization process/ stage among the Greeks. The process was slow but intriguing because the amount of technology was limited.   The architects came up with different design models including doric and ico nic.How did the physical geography of Greece affect the development of the states?The mountains separated the city states; hence the states were able to develop independently.What are the causes of the many contradictions in Classical Greek mythology?There is no concrete evidence that backs the events in the myths. Distortion of the original events is prone to happen, leading to contradictions.How did the Doric style differ from the Ionic style or order of architecture (consider the base, capital, frieze)? Hoplite- meaning an armed infantry.

The Exdous from Egypt Essay Example | Topics and Well Written Essays - 2250 words

The Exdous from Egypt - Essay Example Its final edition was written about 700 years after its actual occurrence, which is a major flaw in historiography 2. According to Egyptian history written by Manetho during the Hellenistic era, Jerusalem was built by Hyksos, who were expelled in Egypt and accordingly, Moses was a leader of lepers who rebelled against Egyptian who got help from Hyksos. In another historical account by Hecateus of Abdera, Jerusalem was built by people who were driven out of Egypt, whose leader is Moses. 3.Some biblical accounts can be corroborated by external evidence. The plagues narrated in chapters 7-12 could be paralleled to the epidemic in mid 4th century, commonly referred to as the Asiatic illness. 4.Some archaeologist believed that Exodus did took place but in a much smaller scale. The accounts of 600,000 who marched on to Read Sea is probably hyperbolic. 5.The story of Exodus reflects ancient metaphors, folklores myth and philosophy. The crossing of the sea is a metaphor to the defeat of the Pharaoh and his army and was probably composed in celebration of the Israelites liberation from the Egyptian slavery, rather than the actual drowning of the pharaoh and his armies. In Hebrew poetry, the imagery of sinking into water is used several times as a metaphor for distress, such as when Jonah is seemingly inside the belly of a whale and in the song of David when he called for divine intervention in Psalm 69. Therefore the sinking of the Pharaoh and his army is a metaphor to the defeat of the pharaoh and their army! Moroever, some Biblical scholars believed that the theophanies in Mt.Sinai, are not originally part of Exodus and that God’s? revelation through the phrase â€Å"I am who I am† is believed to have an undercurrent of the Greek philosophy’s? Absolute being. 6.YHWH is a warrior God that side with the weak which continue to inspire liberation movement of current history. 7.The sources of Exodus is a combination of several traditions namely Yahwist (J),Elohist(E),Deutoronomy (D) and Priestly (P). Exodus 4 which Collins believed to be taken largely from Priestly tradition describes vividly Moses stretching of his hand over the sea and causes the division of water. This should not be taken as a historical account but an attempt to provide concrete expression of YHWH powerful hand in rescuing the Israelites. On the other hand, the presentation of YHWH as a warrior God in Exodus 15 is a clear influence of E tradition in Exodus. My Personal Position in Relation to Arguments Presented Firstly,I fully agree with Mr. Collin’s main contention that it is difficult to establish the historical basis of the whole Exodus. The fact that the Book of Exodus was written about 700 years after its actual occurrence already presents a major flaw in historiography. Moreover, the very limited available non biblical evidence of Jewish history prior to the reign of King David which started around 1,000 BCE is a major challenge .Moreover, the B iblical accounts took place 2 to 3 thousand years before the science of archaeology came into our midst (Miller). But I also agree with him, that Exodus is a literature that speaks of bits and pieces of historical accounts. Previous and recent archaeological findings would attest to it. A.Chariots Found in Gulf of Aqaba in 1978 and 1988 In 1978,Ron Wyatt found numerous chariot wheels with some with axles still on, covered by corals in the Gulf of Aqaba. He also