Little Richards Influence on Rock N Roll History Essay Example for Free

Little Richards Influence on Rock N Roll History Essay Rock and roll music emerged as a part of American teen culture during the notably conservative time period in the country’s history which shortly followed the traumatic events of World War II. Being that the genre’s target audience was white teenagers, many Americans- already overwhelmed and on-edge due to the anti-communist movement inspired by the Cold War- were apprehensive about the influence that this up-and-coming style of music might have on their country’s future. America’s youth openly accepted rock and roll’s racially integrated culture of performers and embraced the relatively lewd nature of many songs and performances associated with the genre, much to the dismay of their elders. Richard Wayne Penniman (better known by his stage name, Little Richard) had an important influence on the history of rock and roll music because of his unconventional stage presence and explicit sexuality. Artists such as Little Richard aggressively pushed the envelope, defied social norms and generated controversy. Richard, along with a few fellow pioneers, helped to define rock and roll in its early years, and paved the way for rock and rollers of future generations. Penniman’s work left an everlasting impression on the musical genre and culture that is rock and roll. Considering the time in America’s history during which Little Richard appeared on the rock and roll scene, it is completely appropriate to attribute much of his fame and influence to his unconventional stage presence. The rising popularity of television during the 1950’s fundamentally changed the music industry by presenting artists with an entirely new way to market themselves (or be marketed). Being televised meant that the overall look and presence of an artist played a more crucial role in stimulating audiences; the focus of listeners was no longer solely the sound of the music being produced. Prior to T. V. , music fans were only able to enjoy the sounds of their favorite artist by way of radio and the purchasing of records. In many cases, this meant that if a fan had never seen a live performance or record-jacket photo of a particular artist, it’s possible that they had never seen said artist at all and possessed only a general idea (if any) of what that artist looked like. As television sets became an increasingly popular household item for middle-class American families, â€Å"live performances assumed a new importance for performers of rock ‘n’ roll music, and individual artists and vocal roups sought to cultivate visual characteristics or mannerisms that would set them apart from others and encourage listeners to remember them†¦ but no performer in the early years of rock ‘n’ roll was as visually flamboyant as Little Richard,† (Schloss, Starr, and Waterman 1-75). A fan’s perception of an artist or group became subject to their opinion of the overall image of the performance. At this point in time, listening to the music of a completely respectable, clean cut, well dressed African-American was still considered inappropriate by a sizeable portion of white American society- particularly those living in the South and those beyond their teenage years. Many of these people were hesitant to accept racial integration, and tended to proceed cautiously when (or, more appropriately, if) they chose to do so. These are the same people that were unrightfully, but understandably, so frightened by performers like Little Richard. In order to differentiate himself from other rockers of the time, Richard usually wore heavy make-up and sported his famous pompadour hair style. As a former drag queen, Richard was fully aware of the type of reaction his look would draw from audiences; it’s the reaction he hoped to receive. Though, at the time, society as a whole was unsure of how to react to the statement his image made, â€Å"the†¦ ambiguity of Little Richard’s sexual identity†¦ paved the way for the image of performers such as David Bowie, Elton John, and Prince,† (Schloss, Starr, and Waterman 1-75). Just in case his eccentric outward appearance was not enough to gain the disapproval of parents across the nation, Little Richard put on an absolutely wild stage performance which included dramatic eye rolling and his simultaneous hip gyrating and piano playing. In order to dance and play piano at the same time, Little Richard stood (not sat) in front of the instrument- yet another feature of his performance that was specific to him. Little Richard aimed to gain the attention of his fans by creating an entirely original and exciting performance act. In order to do so, Richard created an image that was totally outside of society’s definition of normal, respectable, and safe. His image was only half of his act, though. It’s unlikely that there were many ‘respectable’ white, American parents around in the 1950’s that were comfortable with the idea of Little Richard having any type of influence over the generation deemed the ‘future’ of their country, much less over their specific children. If there had been anyone left straddling that fence, however, contemplating just how harmful a 24-year-old performer with a whacky haircut and face full of make up could really be, it would be safe to assume that they had never actually heard the man sing. The lewd, scandalous lyrics that completed Little Richard’s unorthodox self-presentation would have provided the final push that landed the aforementioned fence straddler on the opposite side of Richard’s performance, and confirmed the popular idea that â€Å"rock’s musical characteristics indicated a general decline in American taste,† (Schloss, Starr, and Waterman 1-75). While teenagers danced to the sounds of the modified twelve-bar blues accompanying Richard’s shouting vocal style and countertenor whoops, parents instinctively cringed in disapproval of the blatantly suggestive lyrics. Hit songs by Little Richard such as â€Å"Tutti-Frutti,† (Penniman, 1955) and â€Å"Long Tall Sally,† (Penniman, 1956) contained lyrics that were generally non-specific, but overall relatively sexual for the time. Richard’s scandalous appearance, behavior, and song lyrics embodied a sexual tension that managed to both intrigue teenage audiences, and inspire fellow performers. It is this same sexual tension that made society at large not only generally uncomfortable, but also concerned about what other ludicrous notions rock and roll would try to impose upon American culture in the future. Little Richard used rock and roll as a platform to rattle the cages of the music industry, and change society’s concept of what was acceptable, what was normal, and most of all what was popular. It was Richard’s unique image and abrasive song content that simultaneously intrigued and shocked American society in the early 1950s. American teenagers of this time appreciated the power of Little Richard’s performance and embraced Little Richard as the new spirit of rock and roll. Unfortunately, â€Å"in 1957 Richard denounced his work and joined the church†¦clos[ing] his most creative period,† (Oxford University Press). Although the momentum of his influence eventually slowed, it never quite stopped. Rock and roll performers such as Jerry Lee Lewis, the Beatles, and the American Creedence Clearwater Revival all provide examples of music inspired by the work of Little Richard, proving the power of his influence and solidifying the lasting impression that he left on rock and roll.

Significance of Pharmacovigilance for Drug Safety

Significance of Pharmacovigilance for Drug Safety AIM: To present an overview on the pharmacovigilance practice and realize the significance of pharmacovigilance in envisaging drug safety and efficacy To decisively appraise the pharmacovigilance findings of the anti-diabetic drug Avandia INTRODUCTION AND BACKGROUND INFORMATION: The World Health Organization defines pharmacovigilance as â€Å"The science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem†.9 THE NEED FOR PHARMACOVIGILANCE: Primarily let us understand the need for pharmacovigilance. It has been long debated that the data from animal experiments is not completely worth of extrapolation. The differences in their metabolic pathways, resistance to drugs and various other factors, the pharmacokinetics and dynamics of drugs tend to vary within species to species as well. Extrapolating such statistics from animals to humans though necessary is not foolproof. Additionally, the clinical trial environment is extremely controlled. The patient population, however large, is not a good representative of the general global population. The number of patients is limited. Owing to these facts, an adverse effect, which would occur in one in ten thousand or so, is very unlikely to arise within the restrictions of the clinical trial atmosphere. Moreover, in a real life situation the patients using the drug are likely to have other diseases, consuming other drugs and with different genetic make-ups. Accordingly arises the urgent need for better pharmacovigilance practices. The importance of identifying rare and serious adverse effects of drugs that have remained secret during the course of the clinical trial cannot be ignored. THE STEPS IN PHARMACOVIGILANCE: Spontaneous reporting and prescription event monitoring: Spontaneous reports and prescription event monitoring include reports of adverse effects of drugs to sponsors, CROs or regulatory authorities, reported by patients, nurses, doctors and other healthcare professionals and consumers. The above process is streamlined with the help of global and countrywide structured programs to accelerate the practice and facilitate consumers to testify an adverse effect. Example: the National Pharmacovigilance Program in India. All events that are serious (as defined in ICH-GCP), unexpected, unlabeled, additional efficacy and lack of efficacy should be promptly reported. An incoming report is called as a case report. FDA has defined certain characteristics of a good case report. They are as follows: â€Å"1. Description of the adverse events or disease experience, including time to onset of signs or symptoms; 2. Suspected and concomitant product therapy details (i.e., dose, lot number, schedule, dates, duration), including over-the-counter medications, dietary supplements, and recently discontinued medications; 3. Patient characteristics, including demographic information (e.g., age, race, sex), baseline medical condition prior to product therapy, co-morbid conditions, use of concomitant medications, relevant family history of disease, and presence of other risk factors; 4. Documentation of the diagnosis of the events, including methods used to make the diagnosis; 5. Clinical course of the event and patient outcomes (e.g., hospitalization or death);5 6. Relevant therapeutic measures and laboratory data at baseline, during therapy, and subsequent to therapy, including blood levels, as appropriate; 7. Information about response to dechallenge and rechallenge; and 8. Any other relevant information (e.g., other details relating to the event or information on benefits received by the patient, if important to the assessment of the event).†6 Signal generation: A signal is reported information of the possible causal relationship between an adverse event and the drug, which has been reported more than once. The frequency of reports to generate a signal depends on the seriousness of the event, drug class, disease status, authenticity of the reporter etc. Signal follow-up and strengthening: Signal follow-up and strengthening consists of identifying similar cases in different countries, mining the literature for evidence to support the hypothesis, pre-clinical information and patient follow-up. The prospective analysis of reports of interests is crucial for a signal to generate any action. Careful scrutiny has to be done in order to assess the ingenuity of the signal. The report could have been due to the patients illness history, concomitant medication, disease state or any other reason not related to the use of drug. Even then, such confounded reports should be analyzed promptly. Signal follow-up ensures authenticity of the reports. Causality assessment: Determining whether the adverse event has a causal relationship with the drug or not, and if it has, the degree to which the association exists is called as causality assessment. The WHO has defined six degrees of relationship, namely: certain, probable, possible, unlikely, conditional/unclassified and unassessable/unclassifiable with lowering intensity of causality. Action: Action is taken once it is well established that there exists a causal relationship in between the drug and the adverse event. Depending on the severity of the adverse event, action taken can be in the form of withdrawal of marketing approval, change in package insert, additional trials to confirm causality and dissemination of information globally. THE PRACTICAL ASPECT: Consider the story of the blockbuster drug Avandia (rosiglitazone), used to treat patients with type II diabetes mellitus. â€Å"Rosiglitazone (Avandia ®) is a thiazolidinedione indicated in the treatment of type 2 diabetes mellitus: as monotherapy in patients (particularly overweight patients) inadequately controlled by diet and exercise for whom metformin is inappropriate because of contraindications or intolerance as dual oral therapy in combination with metformin, in patients (particularly overweight patients) with insufficient glycaemic control despite maximal tolerated dose of monotherapy with metformin a sulphonylurea, only in patients who show intolerance to metformin or for whom metformin is contraindicated, with insufficient glycaemic control despite monotherapy with a sulphonylurea as triple oral therapy in combination with metformin and a sulphonylurea, in patients (particularly overweight patients) with insufficient glycaemic control despite dual oral therapy†4 Little did the world know that a boon was in fact a bane for a certain group of people with a history of cardiovascular illnesses. A meta-analysis by Nissen and Wolski et al. provided evidence that â€Å"rosiglitazone was associated with a significant increase in the risk of (MI)myocardial infarction (odds ratio, 1.43; 95% confidence interval [CI], 1.03 to 1.98; P = 0.03) and a borderline-significant finding for death from cardiovascular causes (odds ratio, 1.64; 95% CI, 0.98 to 2.74; P = 0.06).†2 Though the meta-analysis study had quite a few numbers of weaknesses, the increased risk of MI in patients consuming rosiglitazone has come as a rude shock to the sponsors as well as the patient community. Something, which could not be unveiled during the clinical trial process. Another study (called Antipsychotic drugs and heart muscle disorder in international pharmacovigilance: data mining study) by David Coulter et al. used a Bayesian confidence propagation network to analyze the correlation between anti-psychotic drugs and occurrences of cardiomyopathy and myocarditis. Though the study did not prove much, it did bring up an association between use of clozapine and incidences of heart disorders. It also scanned the WHO database and concluded that as compared to other anti-psychotic drugs, clozapine is more widely reported. A French pharmacovigilance study (called Reports of hypoglycemia associated with the use ACE inhibitors and other drugs: a case/non-case study in the French pharmacovigilance system database) by Nicholas Moore et al. set out to find any association between use of ACE inhibitors and incidences of hypoglycemia. The results attested that in fact there was no significant increase in the occurrences of hypoglycemia in patients on ACE inhibi tors. Such pharmacovigilance approaches add to the knowledge base of drugs and related Adverse Drug Reactions. Pharmacovigilance is a vital tool. There are various advances and approaches to good pharmacovigilance practices ranging from data mining studies to conducting global clinical trials. What approach is deemed best to yield the right results, only time will tell. CASE STUDY: THE CHRONICLE OF DIABETES MELLITUS TYPE II, AVANDIA, HOPE AND DEATH! Early in august 2006, Vivians mother had gone to the hospital for some routine cancer tests. However, what was supposed to be routine, did not turn out to be. The doctors found the left side of the patients body swollen. She was admitted immediately. On admission, the doctors found her heart swollen as well. Her heart was racing. Every trick in the trade was tried to get Vivians mother under control, but nothing seemed to work. Just a few days into her admission, she died, of cardiac arrest. Till the end, the doctors failed to find out the root cause for her death. However strange it may seem, the drug which she was taking for the past eight years, to control her blood sugar level has been the prime suspect and the causative agent of edema and myocardial infarction. The name, Avandia; generically known as Rosiglitazone. Vivians mother was put on Avandia since 1999, the drugs approval year. Her death occurred in august 2006. Precisely eight years of Avandia, took her life. Then in May 2007, came to light a stunning NEJM study which spilled the beans for GlaxoSmithKline. They found â€Å"a significant increase 43 percentin the risk for myocardial infarction -with rosiglitazone. They also found a 64 percent increased risk for death from other cardiovascular causes in people taking the drug. These findings were based on analyses of 42 clinical trials of the drug.†10 As a response to this, but probably too late for Vivian and her mother, FDA issued a public warning about the findings of the Avandia pharmacovigilance study. Patients with a bad cardiovascular history were now said to revise their use of Avandia. Either stop it, or lower the dose. The information directly applies to Vivians mother death. Vivian said â€Å"At the time I didnt realize that she had any cardiac problems. But there is a history of heart problems in my mothers family, including a history of heart murmurs. And my brother has a congenital heart defect, my mother was also on at least 13 drugs at the time she went to hospital.†10 A CRITICAL ANALYSIS Thats the tale of one drug and one death. But there have been many. And no noise is being made about it. What approach is the right approach for pharmacovigilance is still to be stereotyped. But so far, the structured ADR reporting systems and data mining seems to have turned the fortunes for Avandia. But for the time being lets spare Avandia, and concentrate our resources towards analyzing the situation of global pharmacovigilance. Does it really happen? What constitutes good pharmacovigilance practice? But one things for sure, the mindsets of sponsors and regulatory authorities needs to change. Things need to get crystallized. Vigilance should be policed. Conditional approval to market the drug should follow stringent laws. The two core issues surrounding pharmacovigilance are drug safety and the reputation of pharmaceuticals. Which one of those needs to be sacrificed does the time arise, is a million dollar question. The reputation, it should be. Compromising drug safety puts millions of patients at risk. Reputation can be back, but life, once gone, never returns, and so is Vivians mother. Even then, the reputation of GSK seems to be untouched. Vivians mother did have a history of cardiovascular illnesses, but still she was on the death drug for over eight years. Such an issue was never raised during any of the trials of Avandia. It is thanks to pharmacovigilance that the root cause analysis was performed and the association between Avandia and edema and myocardial infarction was established. If not completely, at least it has rung the bells at the FDA. It was no doubt too late for Vivians mother, but the information has the potential to save millions of life, now that the correlation has been ascertai ned. However, some issues in the meta-analysis also need to be addressed. The study combined data of 42 different clinical trials. Trials with different outcomes, disease states, patients, duration and many other differentiating factors have been combined to pool in the data. The data from varying trials can be sometimes conflicting. GSK argues, the most reliable way to assess the long-term safety of the trial is to conduct a long-term safety trial. Three long-term safety trials of Avandia have been conducted by GSK. Namely; ADOPT (A Diabetes Outcome Progression Trial), DREAM and RECORD. The studies back Avandias safety profile. No more than a minimalist increase in risk has been noted in one of the studies. Again, as Avandia is known to control the blood sugar level for a longer time, it said to have benefits outweighing the risks. The conflict will always remain. However, in such a scenario, the safety of patients should not in any way take a back seat. Sponsors and regulatory authorities along with consumers and healthcare professionals equal should take serious and committed steps to improve pharmacovigilance. The authenticity of the safety profile of Avandia will be demonstrated over time. But in any case, the death of Vivians mother cannot be reversed, not by me, nor by GSK nor by the FDA. CONCLUSION The coming years are bound to be very interesting on the pharmacovigilance front. The techniques regulatory agencies mandate to make PV more stringent will be worth waiting for. Sponsors will have to invest more money to establish the safety profile of the drug. Awareness among patients has to be created for better reporting of ADRs. The current approach to drug development focuses an intensive, strong and time-consuming pre approval process, but a similar standing is required post approval also. The transition from research to marketing has to be more governed with the research step not stopping at the marketing juncture. BIBLIOGRAPHY: Dhruv Kazi, Rosiglitazone and implications for pharmacovigilance, BMJ 2007;334:1233-1234 (16 June), doi:10.1136/bmj.39245.502546.BE Steven E. Nissen, M.D., and Kathy Wolski, M.P.H., Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death from Cardiovascular Causes, n engl j med 356;24, vol. 356 no. 24 Bruce M. Psaty, M.D., Ph.D., and Curt D. Furberg, M.D., Ph.D., Rosiglitazone and Cardiovascular Risk, n engl j med 356;24 Overview of cardiac adverse drug reactions reported in association with rosiglitazone, Nederlands Bijwerkingen Centrum Lareb November 2007 V. Thawani1, S. Sharma2, K. Gharpure1, Pharmacovigilance: Is it possible if bannable medicines are available over the counter?, Indian J Pharmacol | June 2005 | Vol 37 | Issue 3 Guidance for Industry, Good Pharmacovigilance Practices and Pharmacoepidemiologic Assessment, U.S. Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research (CDER), Center for Biologics Evaluation and Research (CBER), March 2005, Clinical Medical David M Coulter, Andrew Bate, Ronald H B Meyboom, Marie Lindquist, I Ralph Edwards, Antipsychotic drugs and heart muscle disorder in international pharmacovigilance: data mining study, BMJ VOLUME 322 19 MAY 2001, BMJ 2001;322:1207-9 Nicholas Moore et al., Reports of hypoglycemia associated with the use of ACE inhibitors and other drugs: a case/non-case study in French pharmacovigilance sysyem database, Br J Clin Pharmacol1997;44: 513-518, 1997 Blackwell Science Ltd. Data Assessment in Pharmacovigilance (powerpoint presentation), R.H.B. Meyboom Avandia: Meant to Help but Killed Instead March 30, 2008. By Lucy Campbell, Seed Newsvine

Americans Love Capital Punishment :: Argumentative Persuasive Essays

Americans Love Capital Punishment      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   There is one question that has always brought about controversy. Should capital punishment be used as a way of disciplining criminals?   Over the past twenty years, there has been an enormous increase in violent crimes. It seems logical that a person is less likely to commit a given act if by doing so he will suffer swift and certain punishment of a horrible kind.   As most Americans agree, death is the only appropriate punishment for such crimes.      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In ancient times' executions were not uncommon.   Even the Bible teaches capital punishment.   It states, â€Å"Who so sheddeth man's blood, by man shall his blood be shed: for in the image of God made he man† (Bible). In ancient times a set of laws were written which specified many crimes punishable by capital punishment.   These laws were the Code of Hammurabi.   Some of the punishable crimes mentioned included adultery, robbery witchcraft, and murder. During the Middle Ages, the Church assumed the responsibility of administering punishments. During the late 1700's the death penalty steadily grew in acceptance.   Over 200 crimes were punishable by death at the beginning of the 1800's.   There were just as many methods used to execute wrong-doers as there were crimes.   Some of the techniques used included beheading, stoning, drowning, hanging, crucifying, and burying people alive. Also used were many nontraditional forms of execution.   One type of execution utilized elephants to crush the criminal's head on a stone block.      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   As times changed, so did the death penalty.   Laws aimed at abolishing the death penalty began to evolve at the turn of the century.   Even with the changes made, the effectiveness of capital punishment stayed right on track. The crimes punishable by death became more specific, while some were eradicated completely.   For example, there are different types of capital murder that have been specifically defined, but vary from one jurisdiction to another.   These include murder carried out during the commission of another felony, murder of a peace officer, corrections employee, or firefighter engaged in the performance of official duties, murder by an inmate serving a life sentence, and murder for hire (Contract Murder).   Other crimes worthy of death include espionage by a member of the Armed Forces (communication of information to a foreign government), tampering where death results by a witness, and death resulting from aircraft hijacking.   While hangings and firing squads remained in use, many forms of execution were done away with. Methods such as electrocution, lethal gas, and lethal injection soon replaced the annulled ones.   As with almost everything, there were exceptions made.   Some states the prohibited the

Nursing questions Essay

The nurse is performing her admission assessment of a patient. When grading arterial pulses, a 1+ pulse indicates: Above normal perfusion. Absent perfusion. Normal perfusion. Diminished perfusion. Murmurs that indicate heart disease are often accompanied by other symptoms such as: Dyspnea on exertion. Subcutaneous emphysema. Thoracic petechiae. Periorbital edema. Which pregnancy-related physiologic change would place the patient with a history of cardiac disease at the greatest risk of developing severe cardiac problems? Decrease heart rate Decreased cardiac output Increased plasma volume Increased blood pressure The priority nursing diagnosis for the patient with cardiomyopathy is: Anxiety related to risk of declining health status. Ineffective individual coping related to fear of debilitating illness Fluid volume excess related to altered compensatory mechanisms. Decreased cardiac output related to reduced myocardial contractility. A patient with thrombophlebitis reached her expected outcomes of care. Her affected leg appears pink and warm. Her pedal pulse is palpable and there is no edema present. Which step in the nursing process is described above? Planning  Implementation Analysis Evaluation An elderly patient may have sustained a basilar skull fracture after slipping and falling on an icy sidewalk. The nurse knows that basilar skull factures: Are the least significant type of skull fracture. May have cause cerebrospinal fluid (CSF) leaks from the nose or ears. Have no characteristic findings.  Are always surgically repaired.  Which of the following types of drugs might be given to control increased intracranial pressure (ICP)? Barbiturates Carbonic anhydrase inhibitors Anticholinergics Histamine receptor blockers The nurse is teaching family members of a patient with a concussion about the early signs of increased intracranial pressure (ICP). Which of the following would she cite as an early sign of increased ICP? Decreased systolic blood pressure Headache and vomiting Inability to wake the patient with noxious stimuli Dilated pupils that don’t react to light Jessie James is diagnosed with retinal detachment. Which intervention is the most important for this patient? Admitting him to the hospital on strict bed rest Patching both of his eyes Referring him to an ophthalmologist Preparing him for surgery Dr. Bruce Owen, a chemist, sustained a chemical burn to one eye. Which intervention takes priority for a patient with a chemical burn of the eye? Patch the affected eye and call the ophthalmologist. Administer a cycloplegic agent to reduce ciliary spasm. Immediately instill a tropical anesthetic, then irrigate the eye with saline solution. Administer antibiotics to reduce the risk of infection The nurse is assessing a patient and notes a Brudzinski’s sign and Kernig’s sign. These are two classic signs of which of the following disorders? Cerebrovascular accident (CVA) Meningitis Seizure disorder Parkinson’s disease A patient is admitted to the hospital for a brain biopsy. The nurse knows that the most common type of primary brain tumor is: Meningioma. Angioma. Hemangioblastoma. Glioma. The nurse should instruct the patient with Parkinson’s disease to avoid which of the following? Walking in an indoor shopping mall Sitting on the deck on a cool summer evening Walking to the car on a cold winter day Sitting on the beach in the sun on a summer day Gary Jordan suffered a cerebrovascular accident that left her unable to comprehend speech and unable to speak. This type of aphasia is known as: Receptive aphasia Expressive aphasia Global aphasia Conduction aphasia Kelly Smith complains that her headaches are occurring more frequently despite medications. Patients with a history of headaches should be taught to avoid: Freshly prepared meats. Citrus fruits. Skim milk Chocolate Immediately following cerebral aneurysm rupture, the patient usually complains of: Photophobia Explosive headache Seizures Hemiparesis Which of the following is a cause of embolic brain injury? Persistent hypertension Subarachnoid hemorrhage Atrial fibrillation Skull fracture Although Ms. Priestly has a spinal cord injury, she can still have sexual intercourse. Discharge teaching should make her aware that: She must remove indwelling urinary catheter prior to intercourse. She can no longer achieve orgasm. Positioning may be awkward. She can still get pregnant. Ivy Hopkins, age 25, suffered a cervical fracture requiring immobilization with halo traction. When caring for the patient in halo traction, the nurse must: Keep a wrench taped to the halo vest for quick removal if cardiopulmonary resuscitation is necessary. Remove the brace once a day to allow the patient to rest. Encourage the patient to use a pillow under the ring. Remove the brace so that the patient can shower. The nurse asks a patient’s husband if he understands why his wife is receiving nimodipine (Nimotop), since she suffered a cerebral aneurysm rupture. Which response by the husband indicates that he understands the drug’s use? â€Å"Nimodipine replaces calcium.† â€Å"Nimodipine promotes growth of blood vessels in the brain.† â€Å"Nimodipine reduces the brain’s demand for oxygen.† â€Å"Nimodipine reduces vasospasm in the brain.† Many men who suffer spinal injuries continue to be sexually active. The teaching plan for a man with a spinal cord injury should include sexually concerns. Which of the following injuries would most likely prevent erection and ejaculation? C5 C7 T4 S4 Cathy Bates, age 36, is a homemaker who frequently forgets to take her carbamazepine (Tegretol). As a result, she has been experiencing seizures. How can the nurse best help the patient remember to take her medication? Tell her take her medication at bedtime. Instruct her to take her medication after one of her favorite television shows. Explain that she should take her medication with breakfast. Tell her to buy an alarm watch to remind her. Richard Barnes was diagnosed with pneumococcal meningitis. What response by the patient indicates that he understands the precautions necessary with this diagnosis? â€Å"I’m so depressed because I can’t have any visitors for a week.† â€Å"Thank goodness, I’ll only be in isolation for 24 hours.† â€Å"The nurse told me that my urine and stool are also sources of meningitis bacteria.† â€Å"The doctor is a good friend of mine and won’t keep me in isolation.† An early symptom associated with amyotrophic lateral sclerosis (ALS) includes: Fatigue while talking Change in mental status Numbness of the hands and feet Spontaneous fractures When caring for a patient with esophageal varices, the nurse knows that bleeding in this disorder usually stems from: Esophageal perforation Pulmonary hypertension Portal hypertension Peptic ulcers Tiffany Black is diagnosed with type A hepatitis. What special precautions should the nurse take when caring for this patient? Put on a mask and gown before entering the patient’s room. Wear gloves and a gown when removing the patient’s bedpan. Prevent the droplet spread of the organism. Use caution when bringing food to the patient. Discharge instructions for a patient who has been operated on for colorectal cancer include irrigating the colostomy. The nurse knows her teaching is effective when the patient states he’ll contact the doctor if: He experiences abdominal cramping while the irrigant is infusing He has difficulty inserting the irrigation tube into the stoma He expels flatus while the return is running out.  He’s unable to complete the procedure in 1 hour.  The nurse explains to the patient who has an abdominal perineal resection that an indwelling urinary catheter must be kept in place for several days afterward because: It prevents urinary tract infection following surgery.  It prevents urine retention and resulting pressure on the perineal wound It minimizes the risk of wound contamination by the urine.  It determines whether the surgery caused bladder trauma .The first day after, surgery the nurse finds no measurable fecal drainage from a patient’s colostomy stoma. What is the most appropriate nursing intervention? Call the doctor immediately. Obtain an order to irrigate the stoma. Place the patient on bed rest and call the doctor. Continue the current plan of care. If a patient’s GI tract is functioning but he’s unable to take foods by mouth, the preferred method of feeding is: Total parenteral nutrition Peripheral parenteral nutrition Enteral nutrition Oral liquid supplements Which type of solution causes water to shift from the cells into the plasma? Hypertonic Hypotonic Isotonic Alkaline Particles move from an area of greater osmelarity to one of lesser osmolarity through: Active transport Osmosis Diffusion Filtration Which assessment finding indicates dehydration? Tenting of chest skin when pinched Rapid filling of hand veins A pulse that isn’t easily obliterated Neck vein distention Which nursing intervention would most likely lead to a hypo-osmolar state? Performing nasogastric tube irrigation with normal saline solution Weighing the patient daily Administering tap water enema until the return is clear Encouraging the patient with excessive perspiration to dink broth Which assessment finding would indicate an extracellular fluid volume deficit? Bradycardia A central venous pressure of 6 mm Hg Pitting edema An orthostatic blood pressure change A patient with metabolic acidosis has a preexisting problem with the kidneys. Which other organ helps regulate blood pH? Liver Pancreas Lungs heart The nurse considers the patient anuric if the patient; Voids during the nighttime hours Has a urine output of less than 100 ml in 24 hours Has a urine output of at least 100 ml in 2 hours Has pain and burning on urination Which nursing action is appropriate to prevent infection when obtaining a sterile urine specimen from an indwelling urinary catheter? Aspirate urine from the tubing port using a sterile syringe and needle Disconnect the catheter from the tubing and obtain urine Open the drainage bag and pour out some urine Wear sterile gloves when obtaining urine After undergoing a transurethral resection of the prostate to treat benign prostatic hypertrophy, a patient is retuned to the room with continuous bladder irrigation in place. One day later, the patient reports bladder pain. What should the nurse do first? Increase the I.V. flow rate Notify the doctor immediately Assess the irrigation catheter for patency and drainage Administer meperidine (Demerol) as prescribed A patient comes to the hospital complaining of sudden onset of sharp, severe pain originating in the lumbar region and radiating around the side and toward the bladder. The patient also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The doctor tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site? Kidney Ureter Bladder Urethra A patient comes to the hospital complaining of severe pain in the right flank, nausea, and vomiting. The doctor tentatively diagnoses right ureter-olithiasis (renal calculi). When planning this patient’s care, the nurse should assign highest priority to which nursing diagnosis? Pain Risk of infection Altered urinary elimination Altered nutrition: less than body requirements The nurse is reviewing the report of a patient’s routine urinalysis. Which of the following values should the nurse consider abnormal? Specific gravity of 1.002 Urine pH of 3 Absence of protein Absence of glucose A patient with suspected renal insufficiency is scheduled for a comprehensive diagnostic work-up. After the nurse explains the diagnostic tests, the patient asks which part of the kidney â€Å"does the work.† Which answer is correct? The glomerulus Bowman’s capsule The nephron The tubular system During a shock state, the renin-angiotensin-aldosterone system exerts which of the following effects on renal function? Decreased urine output, increased reabsorption of sodium and water Decreased urine output, decreased reabsorption of sodium and water Increased urine output, increased reabsorption of sodium and water Increased urine output, decreased reabsorption of sodium and water While assessing a patient who complained of lower abdominal pressure, the nurse notes a firm mass extending above the symphysis pubis. The nurse suspects: A urinary tract infection Renal calculi An enlarged kidney A distended bladder Gregg Lohan, age 75, is admitted to the medical-surgical floor with weakness and left-sided chest pain. The symptoms have been present for several weeks after a viral illness. Which assessment finding is most symptomatic of pericarditis? Pericardial friction rub Bilateral crackles auscultated at the lung bases Pain unrelieved by a change in position Third heart sound (S3) James King is admitted to the hospital with right-side-heart failure. When assessing him for jugular vein distention, the nurse should position him: Lying on his side with the head of the bed flat. Sitting upright. Flat on his back. Lying on his back with the head of the bed elevated 30 to 45 degrees. The nurse is interviewing a slightly overweight 43-year-old man with mild emphysema and borderline hypertension. He admits to smoking a pack of cigarettes per day. When developing a teaching plan, which of the following should receive highest priority to help decrease respiratory complications? Weight reduction Decreasing salt intake Smoking cessation Decreasing caffeine intake What is the ratio of chest compressions to ventilations when one rescuer performs cardiopulmonary resuscitation (CPR) on an adult? 15:1 15:2 12:1 12:2 When assessing a patient for fluid and electrolyte balance, the nurse is aware that the organs most important in maintaining this balance are the: Pituitary gland and pancreas Liver and gallbladder. Brain stem and heart. Lungs and kidneys.

Child and young person development Essay

1.1 Describe the expected pattern of children and young people’s development from birth to 19yrs Physical Development Communication & Intellectual development Social, Emotional & Behavioural development 0-3 New babies have little control over their bodies, their movement depends on a series of reflexes as they get older they start to develop more gross monitor skills such as crawling, sitting, running, rolling. In their second year, children should have a better ability to control their movement. In a child’s 3rd year they would start to develop fine motor skills such as painting, scribbling and colouring. The child enjoys looking at and turning pages of books. At this age a child, should be able to use a cup and be able to feed themselves. A child at this stage will be listening, taking in language and speech from their surroundings. If a child is not given the appropriate attention they will find it hard to speak/communicate with other children. Speech will begin to grow with the child enjoying songs and games and words will start to increase rapidly, with words being pronounced wrong but not without a lack of trying. For example ‘I broked it’ instead of ‘I b roke it’. Children will have firms bonds with their parents/carers/guardians/key workers. They will experience emotional issues such as playing up for their parents, due to wanting to be independent and do things for themselves. 3-7 At this age, children will be improving the skills they have learned so far, they will have more confidence and more control over their fine motor skills such as cutting, writing and drawing. As children grow they continue to pick up phrases and expressions from the people around them and their surroundings. Their confidence will continue to blossom as they will now be able to talk and communicate in more ways with others around them. Children  will still look for praise from the older people and adults around them. At this age children start to engage more with their friends; ie playing with a ball, dressing up, playing with lego. They will learn disappointment such as not being picked for teams, and know how they should behave within the groups. They will learn to cooperate openly with others and how to respond to responsibility. 7-12 Children would start to have hobbies and interests such as sports, dance, drama. Children will continue to develop and improve many of their skills. Girls will start to show signs of early puberty from age 10-11yrs. Puberty in boys will usually start later. Speech for a child at this stage will be a lot clearer and understood. They will be fine tuning their written and reading skills which will help them to think about ideas and learning tools which will increase their confidence. Their knowledge and understanding will be used a lot more efficiently. Children will have developed different groups of friends and feel settled within those groups. Many different skills will have been developed and hobbies will be of great interest. Fine motor skills will be fully developed with more of an interest in their hobbies. For example playing an instrument, sewing and crafts. 12-19 The boys will be starting to go through puberty and many of the girls would be completing their puberty, having regular periods. As a result of the different stages at this age in puberty, boys and girls will vary in height, with girls they are taller and are growing stronger than boys. A wider understanding of their surroundings and clearer ideas of their favourite activities and subjects at school will be expected at this stage. They will be thinking about future careers as they prepare to leave school. Young people between this age experience a lot of change and can become very self conscious of their bodily changes. Independence will have grown but will still look for guidance from others. Strength, height and confidence will also have grown. 1.2 Describe with examples how different aspects of development can affect one another It is always important to remember that different aspects of development can affect another, for example if a child has a new sibling in their family they have to understand that their parent’s have to share their attention with both of the children not just one. The child may feel angry and alone which can lead to social, emotional and behavioural problems. If they feel they don’t get enough attention from their parents. This can then have an impact on their communication development, due to them playing up or misbehaving. If a child has an illness or disability which prevents them from walking this can affect their physical development as they don’t have full gross motor skill development, as well as affecting their social and intellectual development. They may spend a lot more time learning which will be a positive gain on their intellectual development, however they may wonder why they are not with their peers taking part in their daily activities, therefore their emotional, social and behavioural development will be affected as they may feel left out or different from the others. Outcome 2 2.1 Describe with examples the kinds of influences that affect children and young people’s development including: a) background b) health c)environment Children and young people come from a wide range of different backgrounds, all having an affect on development. For example a child/young person may be neglected and from a poorer family who don’t have the amenities to care properly for that child. The behaviour of a parent towards their child can affect how they deal with things emotionally and therefore can have an impact on a child’s development. If there are older siblings they my talk above the younger sibling or talk for them, having an affect on a child’s communication skills possibly making their speech slower. On a positive note an older sibling may help the younger sibling to develop their skills at a faster pace. For example if they read, write and just sit talking to their  older brother or sister it can help the, to develop much needed skills. If a child/young person suffers a bereavement of a family member or close friend, or has an illness or injury, these factors can also have an affect on a chi ld’s emotional and social development. My daughter Hope, was born with a complex heart and lung defect which led to her having major surgery at 4 months old, this has delayed her development in terms of speech, mobility and learning and she has missed school due to various hospital and clinic appointments. Hope has extra reading lessons as her eyesight has been affected by the health issues and therefore struggles to keep up to the same level as her peers. P.E lessons are sometimes a struggle as her physical ability is behind most of her classmates and she struggles to keep up. Hope’s hearing has also been affected as well as her growth, making it harder for her to complete normal day to day tasks with her friends. The environment a child learns in is an important aspect of their school life. If there are distraction such as a noisy road outside or some kind of issue in the classroom for example a disruptive child, this can affect a child’s development by taking their attention away from learning. A few day nurseries have found recently that bright, vibrant colours and pictures on walls, are more of a distraction to the children in their early years at nursery, and so no longer have anything on walls at all. They are now plain as to not draw attention from the children, distracting them from their day to day learning and play. 2.2 Describe with examples the importance of recognising and responding to concerns about children and young people’s development If a child has any issues it is extremely important that these issues are dealt with as soon as possible, as if they go unnoticed this may lead to further problems. For example my daughter Hope, never showed any signs of having a problem with her eyesight, until a routine check at school discovered she was very short sighted in one eye. It wasn’t until this was found that recent behaviours slotted into place, like Hope wouldn’t look to be interested in class, she would sit and look like she was in a daze, this was due to the fact she couldn’t see properly not that she wasn’t  interested. In Hope’s preschool year, her teacher was concerned Hope wasn’t progressing as well as the other children in her group, due to her being very quiet and reserved and looking disinterested in what was going on. Hope was referred to a learning development team who found nothing wrong, but it was important that her teacher made me aware of these issues incase there was an underlying issue. No matter how many times an issue is raised it is important to do so until the issue has been resolved, so not to cause any further stress to the child or young person. Hope for weeks, wasn’t herself at home or in school, she would be very unsettled, wet the bed, very quiet and wouldn’t join in in her class. After constant revisiting of these problems it was finally found that the anxieties Hope was having was due to her health issues. If these issues were not picked up Hope would be a lot worse now, thankfully they were and are being resolved. Outcome 3 3.1 Identify the transitions experienced by most children and young people Nursery – preschool Preschool – primary school Primary school – high school Change of classes Change of timetable Change of teacher/key worker Puberty 3.2 Identify transitions that only some children and young people may experience Move in house—possibly a local move or out of the area Move in school – due to the above or other personal issues Bereavement of a close friend or family member Illness or injury Parental separation or divorce Change of carer/guardian/new parent New sibling 3.3 Describe with examples how transitions may affect children and young people’s behaviour and development Transitions can affect children in a number of way, during this time it is important that the child or young person has positive relationships around them to help them feel secure. Some transitions can be difficult to deal with and can affect a child or young person’s behaviour in many different ways. For example a child who has just moved house and school can become very clingy, withdrawn, anxious and uninterested in their new surroundings. This can affect their development as they may not join in as much as they should in class, plus could ply up to their new teachers and have behavioural issues. If this kind of behaviour isn’t picked up early on and the child or young person isn’t given the support they need, the transitional period can become a very traumatic experience. On a positive note, a change in school may be what the child needs to take off and thrive in a new setting. It may be seen as an exciting time and a chance for the child to excel in their new surroundings. Any change in a child or young persons life can lead to a number of behvioural and developmental issues. Parental separation or a change in partner can lead to a withdrawn behviour, acting up to gain the attention of their parent. They may become aggressive at the remaining parent and blame themselves for the problems. This behaviour may carry on in school and lead to the child being excluded from the class or school depending on the severity of the situation. If a child or young person experiences illness or an injury, dependent on the severity p, they may need to take a lot of time off school for appointments, treatments, etc. Where some children/young people may see it as a great thing being away from school, for others it can be a very worrying, anxious time. Emotionally they may be down about being here, there and everywhere on different appointments, so it is important that they have a good support network around them to give them some kind of stability during this time. There are a lot of negative affects children and young people can experience  from certain situations, however sometimes positives can be taken from them. For example, as traumatic as it may be for a child to move in with a new parent and new siblings they can be a positive influence in terms of speech and social skills for the young

Deinotherium - Facts and Figures

Deinotherium - Facts and Figures Name: Deinotherium (Greek for terrible mammal); pronounced DIE-no-THEE-ree-um Habitat: Woodlands of Africa and Eurasia Historical Epoch: Middle Miocene-Modern (10 million to 10,000 years ago) Size and Weight: About 16 feet long and 4-5 tons Diet: Plants Distinguishing Characteristics: Large size; downward-curving tusks on lower jaw    About Deinotherium The deino in Deinotherium derives from the same Greek root as the dino in dinosaurthis terrible mammal (actually a genus of prehistoric elephant) was one of the largest non-dinosaur animals ever to roam the earth, rivaled only by contemporary thunder beasts like Brontotherium and Chalicotherium. Apart from its sizable (four to five ton) weight, the most notable feature of Deinotherium was its short, downward-curving tusks, so different from the usual elephant appendages that puzzled 19th-century paleontologists managed to reassemble them upside down.   Deinotherium wasnt directly ancestral to modern-day elephants, instead inhabiting an evolutionary side branch along with close relatives like Amebeledon and Anancus. The type species of this megafauna mammal, D. giganteum, was discovered in Europe in the early 19th century, but subsequent excavations show the course of its peregrinations over the next few million years: from its home base in Europe, Deinotherium radiated eastward, into Asia, but by the start of the Pleistocene epoch it was restricted to Africa. (The other two generally accepted species of Deinotherium are D. indicum, named in 1845, and D. bozasi, named in 1934.) Amazingly, isolated populations of Deinotherium persisted into historical times, until they either succumbed to changing climatic conditions (shortly after the end of the last Ice Age, about 12,000 years ago) or were hunted to extinction by early Homo sapiens. Some scholars speculate that these giant beasts inspired ancient tales of, well, giants, which would make Deinotherium yet another plus-sized megafauna mammal to have fired the imaginations of our distant ancestors (for example, the single-horned Elasmotherium may well have inspired the legend of the unicorn).

The Development of Education essays

The Development of Education essays The twentieth century meant change for every citizen of the United States. With two World Wars, a severe depression, the struggle for the rights of women and minorities, and amazing technological advancements, the country rose and fell sporadically, but always found itself back on top. Because government, economy, and public interest were the focus of the century, the issue of education was an endless matter. Due to this rise in public concern and involvement in education, numerous reforms and advancements have been made to enforce Civil Rights in schools, ensure parental involvement in education, and improve curriculum. At the turn of the century, education had become crucial to much of the population of the United States. Schools were opening across the country and becoming more advanced with every year. There was still one problem; these schools were only available for the white, upper and middle class children. African-Americans tried to open small schools of their own. Some survived, but faced numerous problems. The teachers salaries were so low that they often had to be supplemented by black churches. At the same time, they had shorter school years when they really needed longer to bring the black students to the same level as their long-educated white peers. They taught all classes with a lack of books, desks, and many other supplies much needed to run a school. Two African-American women were very dissatisfied with the condition of the schools. Fanny Jackson Coppin was the first African-American to graduate from Oberlin College. She believed that black children should receive the same quality of education as white children. In 1902, Coppin began a program to train black teachers. She developed classes on school hygiene, reading skills, and how the teachers should effectively present material to their classes. Her programs not only increased the number of qualified teachers in African-American school...