The Water Clock in the Tower of the Winds Essay Example for Free

The Water Clock in the Tower of the Winds Essay Noble and Prices in-depth article examining the specific technical attributes of the water clock in the Tower of Winds in the Roman Agora of Athens purports to be a virtual reconstruction of the Tower of Winds and, specifically, the water-clock and supporting water-tower within. The article is just that and little else. While steadfastly maintaining through out the article that the water-clock and the Tower of Winds have received too little literary and scientific attention over the centuries and lamenting that such a wonderfully curious structure (which has been maintained and continuously occupied over the many centuries since its construction), the authors do little to dramatize the Towers existence or bring the rich archaeological evidence and information made available by the structure into vivid, documentary realization. True enough, the Tower and the water-clock are generally passed over by scholars. An example is G. J. Whitrows mention of the Tower of Winds in his book Time in History: Views of Time from Prehistory to the Present Day which states simply: there is evidence of more elaborate instrumentation, such as the Tower of the Winds which can still be seen in Athens, north of the Acropolis. Designed and built by the astronomer Andronicus Kyrrhestes of Macedonia in the second quarter of the first century BC, with a wind vane and complicated sundials on each of its eight walls, its most interesting feature is a reservoir in a smaller building that stood next to its south side 1 with the implication that the rest of the structure was, in fact, of little interest. Ironically, the very concept of a water-clock provokes a sense of mystery and interest. The origin of water-clocks is presumed to be Egyptians who developed the water-clock as a method for keeping track of time at night when sun-dials were, obviously, incapable of functioning: To provide a means of measuring time at night the Egyptians also invented the water-clock, or clepsydra as the Greeks later called it Vitruvius, writing about 30 BC, described a number of types 2 so the history of the water-clock is deep and richly extensive. The Noble-Price article hints at this rich history for the technological and cultural significance of the water-clock, but evades any real crystallization of the possible incarnations of water-clocks which preceded the massive example in the Tower of Winds. Before examining the strengths and weaknesses of the articles largely technical explication, it may be useful to summarize in general what a water-clock is and what it is intended to do. Although the Noble-Price article certainly fulfills this need for preliminary information, the Columbia Encyclopedia does a far better job of stating, succinctly, the overall historical evolution of the water-clock: More elaborate clepsydras were later developed. Some were double vessels, the larger one below containing a float that rose with the water and marked the hours on a scale. A form more closely foreshadowing the clock had a cord fastened to the float so that it turned a wheel, whose movement indicated the time. A further step was the use of gear wheels and a turning pointer. 3 Another key point of the Noble-Price article relevant to the history of clepsydras is that which demonstrates the distinction between the two major types of water-clocks (or clepsydras) which were used extensively in ancient times: the outflow model and the in-flow model. The article mentions that The outflow clepsydra was known as early as the third millennium B. C. in Egypt, [ ] In this type water is allowed to escape from a vessel by dripping from an orifice near its base. Time is then calculated by measuring the fall of the water level, or the entire period taken for all the water to drain away with the subsequent negative outcome that the rate of flow through the orifice depends on the head of water above it; therefore as the water drains away the flow becomes slower. 4 By contrast, with the inflow device, the invention of which Vitruvius ascribes to Ktesibios, water was fed into a tank somehow equipped to provide a constant head of water. From a small orifice near the bottom of the tank, water dripped at a constant rate into a cylindrical container provided with a float; the float indicated the change in water level and therefore the time elapsed 5 and this solution si evident in the Tower of Winds where The cylindrical tower section of the Tower of the Winds is perfectly suited to house such an apparatus 6. Such technical distinctions are seemingly minor, but play a key role in the pursuit of the article under discussion. As Noble-Price indicate in the articles opening paragraph, the intention of the article is to fill this long-standing lacuna 7 where the captivating archaeological evidence of The Tower of Winds is at long last brought to the attention of serious observers by way of the authors practical restoration of the mechanism designed by Andronikos of Kyrrhos in Macedonia, probably near the beginning of the second half of the first century 8 and the authors certainly fulfill this promise. The shortcoming of the article is its dry, technical explication of the water-clock and Tower which does little to improve upon the authors own dry observation that At the outset it must be admitted that literary and historical allusions to the Tower of the Winds or its designer give almost no indication that the building was anything more than an elaborate wind-vane. 9 By contrast, Suzanne Youngs study, An Athenian Clepsydra, narrates an engaging technical explication along with a dramatic recreation of the function of the clepsydra in the practice of ancient law: Our earliest authority for the clepsydra is Aristophanes. One of his chorus of old Acharnians grumbles that it is hardly fitting that youngsters should shame an old mans grey hairs by dragging him into litigation to destroy him at the clepsydra. 10 Young breaks up her technical explication with historical anecdote and humor: In a slightly later play he teases a jury-court veteran (his chief Wasp ) who never sleeps a wink11 or if he doze off the least bit his mind goes fluttering in the night about the clepsydra. Such an approach finds the reader far more prepared to absorb the more demanding specifications of the technical and cultural attributes under discussion. Similarly, Henry Robinsons article The Tower of the Winds and the Roman Market-Place adopts a narrative-historical approach to the interpretation of the water-clock and Tower, concluding that The Tower of the Winds served as a public time-piece for the city of Athens. Its interior instruments, then, like those in the horologium of Scipio Xasica at Rome, should have been accessible to the populace of the city at all times, both night and day. The absence of one cutting on each threshold block and of one on the floor of the Tower indicates that this was the case 12 and leading the reader to understand the cultural significance of the architecture. Perhaps the Noble-Price article might have benefited from a bit of personal introspection or commentary from the authors outside of that which pertains to the dearth of active scholarship in relation to their chosen subject for the article. Unfortunately, the authors vividly miss any opportunity to include such material, or even a bit of comic relief as is evident in Carl W. Blegans article Prosymna: Remains of Post-Mycenaean Date which catelogs a tremendous amount of information on a dizzying array of artifacts and manages to compress this information into an entertaining and memorable package. Perhaps it is necessary for the human mind to punctuate its absorption of information with cutaway moments of emotional reflection, humor, and introspection. If so, the Noble-Price article suffers greatly from its lack of such punctuated emotion. The Blegen article, for example, finishes with a bit of humor and mystery, describing an ancient Egyptian artifact: The arcs and the lines are for the most part accurately and carefully drawn. The zodiacal names and the numerals of the hours are written in fairly well formed letters which seem to belong to the end of the second century B. c. , and we may conclude that the sphere was made about that time. The dedicatory inscription, on the other hand, with its crowded, badly shaped letters, regular use of t for Z, EI for 0, and for R,must be a much later addition, perhaps assignable to the second century A. D. whatever its earlier history, the sun-dial was presumably at that time dedicated to Hera and set up in the sanctuary; from which it must subsequently have rolled down the hill to the place where it was found. 13 In conclusion, while the Noble-Price article does an admirable job of presenting technical details, is deeply researched, and honestly intended, the article lacks any narrative or dramatic intensity which and will likely do little to exhume the Tower of the Winds from scholarly or popular obscurity. NOTES 1. G. J. Whitrow, Time in History: Views of Time from Prehistory to the Present Day (Oxford: Oxford University Press, 1989), 50. 2 G. J.Whitrow, Time in History: Views of Time from Prehistory to the Present Day (Oxford: Oxford University Press, 1989), 27. ) 3. The Columbia Encyclopedia 6th ed. , s. v. Clepsydra, 4. Noble Joseph V. ; de Solla Price Derek J. The Water Clock in the Tower of the Winds American Journal of Archaeology, Vol. 72, No. 4. (Oct. , 1968), p. 351. 5. Noble Joseph V. ; de Solla Price Derek J. The Water Clock in the Tower of the Winds American Journal of Archaeology, Vol. 72, No. 4. (Oct. , 1968), p. 346. 6. Noble Joseph V. ; de Solla Price Derek J. The Water Clock in the Tower of the Winds American Journal of Archaeology, Vol. 72, No. 4. (Oct. , 1968), p. 346. 7. Noble Joseph V. ; de Solla Price Derek J. The Water Clock in the Tower of the Winds American Journal of Archaeology, Vol. 72, No. 4. (Oct. , 1968), p. 346. 8. Noble Joseph V. ; de Solla Price Derek J. The Water Clock in the Tower of the Winds American Journal of Archaeology, Vol. 72, No. 4. (Oct. , 1968), 351. 9. Noble Joseph V. ; de Solla Price Derek J. The Water Clock in the Tower of the Winds American Journal of Archaeology, Vol. 72, No. 4. (Oct. , 1968), 352. 10. Young, Suzanne. An Athenian Clepsydra Hesperia, Vol. 8, No. 3, The American Excavations in the Athenian Agora: Sixteenth Report. (Jul. Sep. , 1939), pp. 276. 11. Young, Suzanne. An Athenian Clepsydra Hesperia, Vol. 8, No. 3, The American Excavations in the Athenian Agora: Sixteenth Report. (Jul. Sep. , 1939), pp. 276. 12. Robinson, Henry S. The Tower of the Winds and the Roman Market-Place American Journal of Archaeology, Vol. 47, No. 3. (Jul. Sep. , 1943), pp. 295. 13. Blegen, Carl W. Prosymna: Remains of Post-Mycenaean Date American Journal of Archaeology, Vol. 43, No. 3. (Jul. Sep. , 1939), pp. 444.

Study Effectiveness Of Nebulization Improving Childrens Respiratory Status Nursing Essay

Study Effectiveness Of Nebulization Improving Childrens Respiratory Status Nursing Essay Data analysis is the systematic organization and synthesis of research data and testing of research hypothesis using those data. Interpretation is the process of making sense of the result and examining their implication (Polit, 2004). Analysis is the method of rendering qualitative data meaningful and providing intelligible information, so that the research problem can be studied and tested, including the relationship between the variables. The study was conducted among children with wheezing to compare the effectiveness of nebulization with oxygen and without oxygen in improving their respiratory status. The data was collected, assembled, analyzed and tested and the findings based on the analysis are presented in this chapter. 4.1 Demographic Variables of Children with Wheezing: The age of the children with wheezing ranged between one month to five years. Out of this, 8 (16%) children were between the age group of one month to one year, 17 (34%) were between 1-3 years and 25 (50%) were between the age group of 3-5 years. Majority of the children were males (62%) and female children were 38%. 34 (68%) children belonged to nuclear family whereas 16 (32%) children belonged to joint family. LPG was used as the cooking fuel in all (100%) the houses (Table 4.1). 4.2 Family History of Smoking Habits: In nebulization with oxygen group, 5(20%) children had the family history of smoking habit. For majority (4) of children, grandfather was the person who smokes and for one child father was the smoking person. In nebulization without oxygen group, fathers of 3(12%) children smoke in the family (Table 4.2). 4.3 Family History of Respiratory Diseases: 5 (20%) children in the nebulization with oxygen group had a family history of asthma, out of which one person is on regular treatment. In nebulization without oxygen group, 5(20%) children had a family history of asthma and 3(12%) had a family history of COPD, out of which one person is on regular treatment (Table4.3). 4.4 History of Respiratory Diseases in Children: With regard to previous history of respiratory diseases, majority (64%) of children had wheeze associated lower respiratory infection (WALRI) in nebulization with oxygen group whereas in nebulization without oxygen group, 15 (60%) children had WALRI, .6 (24%) children had hyper reactive airway disease (HRAD) and 3 (12%) children had asthma in nebulization with oxygen group , whereas in nebulization without oxygen group,7 (28%) children had asthma and 3 (12%) had HRAD (Table.4.4). About the onset of respiratory diseases, 14 (56%) children developed respiratory diseases before 1year of age and 5 (20%) children developed between the age group of 1-2 years in nebulization with oxygen group whereas in nebulization without oxygen group, 10 (40%) children developed before 1year of age and 7 (28%) children developed between 1-2 years of age (Table.4.4). Regarding the duration of the disease, 14 (56%) children had the duration of disease less than a year and 6 (24%) had the duration between1-2 years in nebulization with oxygen group whereas in nebulization without oxygen group, 11 (44%) children had duration of less than 1 year and 8 (32%) had the duration between 1-2 years (Table.4.4). With regard to the regularity of the treatment, 3(12%) children in the nebulization with oxygen group and 6 (24%) children in the nebulization without oxygen group were on regular treatment. All these children were using inhalers. Majority of the children (66.66%) were using a combination of salbutamol -fluticosone inhaler in both groups and the rest (33.33%) were using asthalin alone (Table.4.4). 4.5 Immunization History: All the children (100%) in both groups were completely immunized. 4.6 Pre assessment of Respiratory Parameters in Nebulization with Oxygen Group: The initial assessment of respiratory rate of children in nebulization with oxygen group showed that 6 (24%) children were in mild distress, 6 (24%) children were in moderate distress and 13 (52%) children were in severe distress. In the assessment of oxygen saturation, 20 (80%) children had mild desaturation (95-97% in room air) and 5 (20%) children had moderate desaturation (90-94%in room air).In the initial assessment of wheezing, 12 (48%) children were having wheezing on terminal expiration and 13 (52%) children were having wheezing on entire expiration.The assessment of retraction showed that 16 (64%) children were normal, 8(32%) children had intercostal retractions and 1 (4%) child had intercostal and substernal retractions..In the initial dyspnoea assessment, 5 (20%) children were having mild dyspnoea and 20 (80%) children were normal (Table 4.5). 4.7 Pre assessment of Respiratory Parameters in Nebulization without Oxygen Group: The initial respiratory rate assessment of children in nebulization without oxygen group showed that 10 (40%) children were in mild distress, 8 (32%) children were in moderate distress and 7 (28%) children were in severe distress. In the assessment of oxygen saturation, 22 (88%) children had mild desaturation (95-97% in room air) and 3 (12%) children had moderate desaturation (90-94%in room air). In the initial assessment of wheezing, 17 (68%) children were having wheezing on terminal expiration and 8 (32%) children were having wheezing on entire expiration. Initial retraction assessment showed that 18 (72%) children had intercostal retractions and 7 (28%) children had intercostal and substernal retractions. In the assessment of dyspnoea, 5 (20%) children were having mild dyspnoea and 20 (80%) children were normal (Table 4.6). 4.8 Implementation of Therapies among Children with Wheezing: 4.8.1 Administration of nebulization with oxygen: Nebulization with oxygen was provided to 25 children with wheezing who were prescribed for Combimist nebulization in the OPD. Nebulization was provided by the staff nurse for a period of 15-20 minutes. Children who were on treatment prior to the nebulization were not included in the study. Assessment was done before and after nebulization with oxygen. 4.8.2 Administration of nebulization without oxygen: Nebulization without oxygen was provided by the staff nurse to 25 children with wheezing who were prescribed with Combimist (Salbutamol+ Ipravent) nebulization in the OPD. Nebulization was provided for a period of 15-20 minutes. Children who were on treatment prior to the nebulization were not included in the study. Assessment was done before and after nebulization with oxygen. 4.9: Post assessment of Respiratory Parameters in Nebulization with Oxygen Group: 4.9.1 Post Assessment at 5 Minutes: In the post 5 minutes assessment of respiratory rate of children in nebulization with oxygen group,1 (4%) child reached normal ,7 (28%) children were in mild distress,5 (20%) children were in moderate distress and 12 (48%) were in severe distress. In the assessment of oxygen saturation, 4 (16%) children reached normal saturation, 17 (68%) children had mild desaturation (95-97% in room air) and 4 (16%) children had moderate desaturation (90-94%in room air). Wheeze assessment showed that 1 (4%) child became normal, 13 (52%) children were having wheezing on terminal expiration and 11 (44%) children were having wheezing on entire expiration. In the assessment of retraction, 16 (64%) children were normal, 8 (32%) children had intercostal retractions and 1 (4%) child had intercostal and substernal retractions.In the dyspnoea assessment, 5 (20%) children were having mild dyspnoea and 20 (80%) children were normal (Table 4.5). 4.9.2 Post Assessment at 10 Minutes: In the post 10 minutes assessment of respiratory rate of children,1 (4%) child reached normal ,8 (32%) children were in mild distress,7 (28%) children were in moderate distress and 9 (36%) were in severe distress. Assessment of oxygen saturation revealed that 13 (52%) children were having normal saturation, 11 (44%) children had mild desaturation (95-97% in room air) and 1 (4%) child had moderate desaturation (90-94%in room air). In the assessment of wheezing, 10 (40%) children were relieved from wheezing, 11 (44%) children were having wheezing on terminal expiration and 4 (16%) children were having wheezing on entire expiration. Assessment of retractions showed that 21 (84%) children became normal, 4 (16%) children had intercostal retractions.In the dyspnoea assessment, 22 (88%) children were having no dyspnoea and 3 (12%) children were having mild dyspnoea (Table 4.5). 4.9.3 Post Assessment at 15 Minutes: Post 15 minutes assessment of respiratory rate showed that 5 (20%) child reached normal ,5 (20%) children were in mild distress,9 (36%) children were in moderate distress and 6 (24%) were in severe distress. In the assessment of oxygen saturation, 17 (68%) children reached normal saturation, 8 (32%) children had mild desaturation (95-97% in room air). In the assessment of wheezing, 12 (48%) children were relieved from wheezing, 12 (48%) children were having wheezing on terminal expiration and 1(4%) child was having wheezing on entire expiration. The assessment of retractions revealed that 23 (92%) children became normal, 2 (8%) children had intercostal retractions.Dyspnoea assessment showed that 23 (92%) children became normal and 2 (8%) children were having mild dyspnoea (Table 4.5). 4.9.4 Post Assessment at 30 Minutes: Post 30 assessment of respiratory rate showed that 11 (44%) child reached normal, 7 (28%) children were in mild distress, and 4 (16%) children were in moderate distress and 3 (12%) were in severe distress. In the assessment of oxygen saturation, 19 (76%) children reached normal saturation, 5 (20%) children had mild desaturation (95-97% in room air) and 1 (4%) child had moderate desaturation. In the assessment of wheezing, 14 (56%) children were relieved from wheezing, 11 (44%) children were having wheezing on terminal expiration. The assessment of retractions showed that 24 (96%) children became normal, 1 (4%) children had intercostal retractions. Dyspnoea assessment revealed that 23 (92%) children reached normal and 2 (8%) children were having mild dyspnoea (Table 4.5). 4.10 Post assessment of Respiratory Parameters in Nebulization without Oxygen Group: 4.10.1 Post Assessment at 5 Minutes: Post assessment of respiratory rate showed that 11 (44%) children were in mild distress, 8 (32%) children were in moderate distress and 6 (24%) were in severe distress. In the assessment of oxygen saturation, 1 (4%) child reached normal, 21 (84%) children had mild desaturation (95-97% in room air) and 3 (12%) children had moderate desaturation (90-94%in room air).Assessment of wheezing showed that 2 (8%) children became normal, 15 (60%) children were having wheezing on terminal expiration and 8 (32%) children were having wheezing on entire expiration. In the assessment of retraction, 19 (76%) children had intercostal retractions and 6 (24%) children had intercostal and substernal retractions. Dyspnoea assessment showed that 5 (20%) children were having mild dyspnoea and 20 (80%) children were normal (Table 4.6). 4.10.2 Post Assessment at 10 Minutes: Post 10 minutes assessment of respiratory rate revealed that 4 (16%) children reached normal rate, 10 (40%) children were in mild distress,7 (28%) children were in moderate distress and 4 (16%) were in severe distress. In the assessment of oxygen saturation, 7 (28%) children reached normal, 15 (60%) children had mild desaturation (95-97% in room air) and 3 (12%) children had moderate desaturation (90-94%in room air). Assessment of wheezing showed that 16 (64%) children became normal, 4 (16%) children were having wheezing on terminal expiration and 5 (20%) children were having wheezing on entire expiration. In the assessment of retraction, 22 (88%) children became normal and 3 (12%) children had intercostal retractions. Dyspnoea assessment revealed that, 3 (12%) children were having mild dyspnoea and 22 (88%) children became normal (Table 4.6). 4.10.3 Post Assessment at 15 Minutes: In the post assessment of respiratory rate,9 (36%) children reached to normal rate, 7 (28%) children were in mild distress, 5 (20%) children were in moderate distress and 4 (16%) were in severe distress. The post assessment of oxygen saturation showed that 10 (40%) children reached normal, 13 (52%) children had mild desaturation (95-97% in room air) and 2 (8%) children had moderate desaturation (90-94%in room air). Wheeze assessment at 15 minutes showed that 19 (76%) children became normal, 6 (24%) children were having wheezing on terminal expiration. In the assessment of retraction, 24 (96%) children became normal, 1 (4%) children had intercostal retractions. Evaluation of dyspnoea revealed that 2 (8%) children were having mild dyspnoea and 23 (92%) children were normal (Table 4.6). 4.10.4 Post Assessment at 30 Minutes: Post assessment of respiratory rate showed that 13 (52%) children reached normal rate, 7 (28%) children were in mild distress, 2 (8%) children were in moderate distress and 3 (12%) were in severe distress. In the assessment of oxygen saturation, 10 (40%) child reached normal, 13 (52%) children had mild desaturation (95-97% in room air) and 2 (8%) children had moderate desaturation (90-94%in room air). In the assessment of wheezing, 19 (76%) children became normal, 6 (24%) children were having wheezing on terminal expiration. Assessment of retraction revealed that 24 (96%) children had no retractions, 1 (4%) children had intercostal retractions.Dyspnoea assessment showed that1 (4%) child was having mild dyspnoea and 24 (96%) children became normal (Table 4.6). 4.11 Comparison of Mean Difference of Pre and Post Assessment of Respiratory Parameters in Nebulization with Oxygen Group and Nebulization without Oxygen Group: 4.11.1 Mean Difference of Respiratory Rate in Nebulization with Oxygen Group and Nebulization without Oxygen Group: In nebulization with oxygen group, the pre mean values of respiratory rate was 41.68 and post mean value at 5 minutes was 40.4.Post mean values at 10 minutes was 37.76, at 15 minutes was 35.6 and at 30 minutes was 32.8. The mean difference between pre and post respiratory rate at 30 minutes was 8.88. This shows a significant reduction in respiratory rate after nebulization with oxygen. The pre mean value of respiratory rate in nebulization without oxygen group was 36.64 .The post mean value of respiratory rate at 5 minute was 36, at 10 minutes was 34.32, at 15 minutes was 32.48 and at 30 minutes was 30.96. The mean difference between pre and post respiratory rate at 30 minutes was 5.68. This shows a reduction in respiratory rate after nebulization without oxygen. Therefore, it can be inferred that the mean difference was high in nebulization with oxygen group comparing to nebulization without oxygen group. This showed that nebulization with oxygen is effective in reducing tachypnea among children with wheezing (Table 4.7). 4.11.2 Mean Difference of Oxygen Saturation in Nebulization with Oxygen Group and Nebulization without Oxygen Group: Oxygen saturation above 98% in room air is considered as the normal saturation level. The pre mean value of oxygen saturation in nebulization with oxygen group was 95.24. The post mean value of oxygen saturation at 5 minute was 96, at 10 minutes was 97.24, at 15 minutes was 98.08 and at 30 minutes was 98.32. The mean difference between pre and post oxygen saturation at 30 minutes was 3.08. This shows an improvement in oxygen saturation after nebulization with oxygen. The pre mean value of oxygen saturation in nebulization without oxygen group was 95.72 .The post mean value of oxygen saturation at 5 minute was 95.88, at 10 minutes was 96.68 at, 15 minutes was 97.36 and at 30 minutes was 97.08. The mean difference between pre and post respiratory rate at 30 minutes was 1.36. Therefore, it can be inferred that the mean difference was high in nebulization with oxygen group comparing to nebulization without oxygen group. This showed that nebulization with oxygen is effective in improving the oxygen saturation among children with wheezing (Table 4.7). 4.11.3 Mean Difference of Wheeze Score in Nebulization with Oxygen Group and Nebulization without Oxygen Group: Auscultation of normal vesicular breath sounds is considered as normal. The pre mean value of wheeze score in nebulization with oxygen group was 1.52. The post mean value of wheeze score at 5 minute was 1.4, at 10 minutes was 0.72, at 15 minutes was 0.56 and at 30 minutes was 0.44. The mean difference between pre and post wheeze score at 30 minutes was1.08. This showed an improvement in wheeze score after nebulization with oxygen. The pre mean value of wheeze score in nebulization without oxygen group was 1.32. The post mean value of wheeze score at 5 minute was 1.12, at 10 minutes was 0.56, at 15 minutes was 0.24 and at 30 minutes was 0.24. The mean difference between pre and post wheeze score at 30 minutes was 1.08. This showed that there was no mean difference in wheeze score in nebulization with oxygen group and nebulization without oxygen group. Hence, nebulization with oxygen and nebulization without oxygen has similar effect in reducing wheeze score among children with wheezing (Table 4.7). 4.11.4 Mean Difference of Retraction Score in Nebulization with Oxygen Group and Nebulization without Oxygen Group: Observation of normal chest movements is considered as normal. In nebulization with oxygen group, the pre mean value of retraction score was 0.4. The post mean value of retraction score at 5 minute were 0.4, at 10 minutes was 0.16, at 15 minutes was 0.08 and at 30 minutes was 0.04. The mean difference between pre and post wheeze score at 30 minutes was 0.36. This showed an improvement retraction score in nebulization with oxygen group. The pre mean value of retraction score in nebulization without oxygen group was 0.28. The post mean value of retraction score at 5 minute was 024, at 10 minutes was 0.12, at 15 minutes was 0.04 and at 30 minutes was 0.04. The mean difference between pre and post retraction score at 30 minutes was 0.24. This showed that there was no mean difference in retraction score in nebulization with oxygen group and nebulization without oxygen group. Hence, nebulization with oxygen and nebulization without oxygen has similar effect in reducing retraction score among children with wheezing (Table 4.7). 4.11.5 Mean Difference of Dyspnoea Grade in Nebulization with Oxygen Group and Nebulization without Oxygen Group: Grade 0 is regarded as absence of dyspnoea. In nebulization with oxygen group, the pre mean value of dyspnoea grade was 0.2. The post mean values of dyspnoea grade at 5 minute were 0.2, at 10 minutes was 0.12, at 15 minutes was 0.08 and at 30 minutes was 0.08. The mean difference between pre and post dyspnoea grade at 30 minutes was 0.12. This showed an improvement in dyspnoea grade in nebulization with oxygen group. The pre mean value of dyspnoea grade in nebulization without oxygen group was 0.2. The post mean values of dyspnoea grade at 5 minute was 0.2, at 10 minutes was 0.12 ,at 15 minutes was 0..08 and at 30 minutes was 0..04. The mean difference between pre and post dyspnoea grade at 30 minutes was 0.16. Hence the result highlighted that the mean difference was slightly higher in nebulization without oxygen comparing to nebulization with oxygen. This showed that nebulization with oxygen had similar effect in reducing dyspnoea grade among children with wheezing (Table 4.7). 4.12. Effectiveness of Nebulization with Oxygen in Improving the Respiratory Parameters among Children with Wheezing through Pairedt test Analysis: Paired t test was used to assess the differences in pre and post assessments of respiratory parameters among nebulization with oxygen group. (Table 4.8). 4.12.1 Comparison of Pre and Post 5 Minutes, 10 Minutes, 15 Minutes and 30 Minutes Assessment of Respiratory Rate in Nebulization with Oxygen Group: Hypothesis: There will be a significant difference in pre and post assessment of respiratory rate in nebulization with oxygen group. t = t5min = =2.67 t10min = =5 t15min = =7.89 t30min= =12.94 The calculated values of t at 5,10,15 and 30 minutes are 2.67, 5, 7.89 and 12.94 respectively which are greater than the tabulated value at p

evilmac Supernatural in Shakespeares Macbeth - The Evil Witches :: GCSE Coursework Macbeth Essays

Macbeth’s Evil Witches  Ã‚      The witches are seen as being evil. This is because at the time, witches were accepted as being real and evil. Shown in the play because the first scene is thunder and lightning, which is associated with terrible happenings and things so suggests witches are terrible things. They speak in rhymes and use many equivocal terms e.g. ‘Fair is foul, and foul is fair’. This suggests reversal and unbalance, which leads to chaos and disorder in Macbeth’s life. This is suggested because they immediately mention Macbeth so he is already associated with the witches and seen as being evil. The chaos is also shown in the natural world by the weather and natural events. Act 1 Scene 3, there is thunder when the witches meet again. The idea of them being evil is reinforced because in this scene because they are cursing a sailor. This suggests that Macbeth will also face a similar type of treatment. The mystery of the witches is increased in this scene because they know Macbeth is coming when the third witch tells the other two, ‘Macbeth doth come.’ This raises the question of how they knew he was coming and reinforces the link between Macbeth and the witches, which suggests to the audience that Macbeth is evil from the beginning of the play. This link is further reinforced when Macbeth’s first line using the same equivocal as the witches, ‘So foul and fair a day I have not seen’. Banquo is wary of the witches and does not really want to believe that they really because he says ‘That look not like th’ inhabitants o’ th’ earth’, which adds further to their mystery because they are described as being unnatural. However, the suggestion that Macbeth is somehow acquainted with them is again shown when he talks to them directly without fear and asks 'What are you?’ Nevertheless, this shows to an extent that Macbeth also saw the witches as being unnatural because he enquires about what they are but he does not appear to be afraid. They then avoid this question and tell Macbeth his prophecies as though this was the purpose all along. Their prophecies give rise to the question whether they knew that he was already Thane of Glamis and the next Thane of Cawdor. This adds to the mystery of the witches and provides some more evidence of the suggestion that they were well acquainted with Macbeth.

Life in Brave New World and Life in America :: Brave New World

Life in Brave New World and Life in America For more than half a century, science fiction writers have thrilled and challenged readers with visions of the future and future worlds. These authors offered an insight into what they expected man, society, and life to be like at some future time. A society can achieve stability only when everyone is happy, and the brave new world tries hard to ensure that every person is happy. It does its best to eliminate any painful emotion, which means every deep feeling and passion. It uses genetic engineering and conditioning to ensure that everyone is happy with his or her work. Sex is a primary source of happiness. The brave new world basically teaches everyone to be promiscuous. You are allowed to have sex with any partner you want, who wants you, and sooner or later every partner will want you. Children are taught through hypnosis that "everyone belongs to everyone else." In this Utopia, what we think of as true love for one person would lead to a passion for that person and the establishment of family life, both of which would interfere with the community and its stability. Nobody is allowed to become pregnant because nobody is born, everyone is a "test-tube" baby. Many females are born sterile. The ideas and ways of obtaining happiness are not too much different in the brave new world than in our lives here in the United States. The only difference is that these pleasures are looked at in different ways. Sex is a very large part of our society's pleasure and everyone is allowed to have any partner that he/she wants, but this idea is not taught at a young age and everyone in our society does not feel this way towards sex. Our ideas and thoughts on topics of this nature are much more broad, and everyone is entitled to his/her own opinion. Families are established in our culture, which are looked upon as something very good for our society. Women are allowed to become pregnant as freely as they want and the government will even aid them in the process. This is one difference that is totally different from the brave new world. Women were a lot of times not even allowed to have children much less have as many as they so desired. Soma is a drug used by everyone in the brave new world almost everyday It calms people and gets them high at the same time, but without hangovers or nasty side effects. The rulers of the brave new world had put 2000

Compare and contrast these two poems Essay

† Upon first glance you do not realise exactly how much irony and skilful use of literary devices there are in this poem. But this poem creates pity also; maybe the poet himself has been through an experience like this and felt so strongly about it that he wrote this poem. ‘The Fringe of the Sea’ creates envy, longing and calm. â€Å"We want to be able to saunter beside it Slowpaced in burning sunlight,† The charming scene brought to mind by this poem, epitomises the respect and awe that the poet has for the sea: â€Å"elegant in high blue chambers. † This gives a much more traditional and kindly view of the sea. The simile in ‘The Fringe of the Sea’: â€Å"like farmers do with soil,†-comparing the soil to the sea, shows dependence and need, showing indeed that the sea ‘is an essential part’ of Paul Keens-Douglas’ ‘psyche’. It is interesting that A. L Hendriks’ similes are connected to land objects. Showing that he is indeed a land person and is unused to the sea. He compares the mast to â€Å"two tree growin. † Likens a wave to a ‘mountain’ and the â€Å"foam all roun de boat like soap. † He compares these new, strange things he sees, to comforting, stable, straightforward objects. This makes him seem honest and of a lesser intelligence somehow, even though he isn’t. We see his simplicity in his choice of images. Paul Keens-Douglas uses such obvious, humble verbs, showing his positive and thoughtful attitude to the idyllic world that he is at peace with. He lists the mundane necessity â€Å"to work† equally with such pleasant verbs as: â€Å"to walk† â€Å"dive and swim and play† Showing that to him even work is enjoyable and just a natural part of his day. The author’s repetition of the word â€Å"We† gives the idea that there is a whole ranges of people whose lifestyle is in harmony with the sea. All of verse two tells you this: â€Å"We like to rise up early, quick in the agile mornings and walk down only little distances to look down at the water† It gives the impression of a much-valued relative who they are â€Å"quick† to visit eagerly each day. The use of ellipsis in â€Å"Windjammer† creates a much fuller picture. Words like â€Å"rattlin’,† â€Å"growin’,† â€Å"cuttin’,† â€Å"swingin’,† and â€Å"makin’,† assist the use of dialect in making you hear the poem in your head. Ellipsis also seems to create familiarity with reader as if there is no need to standardise the English, as you might to someone of importance. Dialect and Ellipsis often seem to give this effect, although often, in reality, familiarity is not intended or intentional. Also, the lines: â€Å"An’ is up an’ down up an’ down In an’ out, in an’ out,† give a fuller picture as the rhythm gives a wave effect. In the onomatopoeic words â€Å"swish- swishing† you can almost hear the sloshing around as the â€Å"boat bow† is â€Å"cuttin’ water. † The use of personification in ‘ The Fringe of the Sea’ in the word â€Å"murmurs† sounds like an undercurrent or maybe even a lover or a mother, gently whispering to the metaphoric â€Å"sandless highways†. Strange, that you have the word â€Å"mutterin’ † in ‘Windjammer. ‘ This word personifies a moody threatening presence, like some sullen child muttering under their breath. These key words are completely opposite in their effect. The line â€Å"Sun bussin’ me skin,† in ‘Windjammer’, is also personification. It brings to mind a picture, of a comfy brown shoe, being polished. Like the sun is rubbing away at the narrator’s cheeks. In this line, there is use of alliteration of the sibilant sound â€Å"S. † It’s a hissing sound, so it seems the author is annoyed that he is going to get sunburnt. This line is followed by: â€Å"Ah bound to peel, An’ me done so black already. † Which is humorous and he seems to be self-ridiculing in his unfortunate situation. Opposite to this, the personification in ‘The Fringe of the Sea’ is totally serious, as is the whole poem. The poet describes the seas â€Å"call. † This gives the effect of authority and possession, like man is the sea’s servant. The lines: â€Å"with songs and tides and endless boatways, and undulate patterns and moods. † give the impression of a powerful, varied and vibrant presence, ever changing. This is ironic since the sea is â€Å"endless† and is presumed to be always the same. Situational Comedy is extensively used in ‘Windjammer. ‘ When A. L Hendriks writes â€Å"Is alright for dem sailor† â€Å"An’ talkin’ bout how is ah calm day. If dis is calm, well, Jesus help, Ah wouldn’t want to see when it rough. † This shows the narrator’s fear and puzzlement in the poem. There is comedy in the use of the vulgarisms â€Å"wish to god†, â€Å"Jesus help† and â€Å"Watch yu arse or yu head gone. † They really do express and emphasise the narrator’s funny anguish. No comedy at all is used in ‘The Fringe of the Sea’ it is completely serious, meek and unassuming-too respectful to poke fun at the sea. The use of rhetorical questions enhances the parody of ‘Windjammer: â€Å"who sen’ me eh? Who sen’ me? † In ‘The Fringe of the Sea’ there are no rhetorical questions, everything is stated as fact. The simple statements do not allow for doubt. ‘The Fringe of the Sea’ is my favourite poem out of the two. Everything in it is pensive, drifting along with dream like quality, with the wise, intelligent man in his perfect world. But my favourite line has to come from ‘Windjammer’ as this poem has so much enthusiasm, even in the terrible situation that the man is in. The last line is the best: â€Å"Dem seasick pills don’t work neither†¦ † It seems that it was an afterthought, not as important as the rest of the poem, but it gives you the most insight into the narrators feelings and is definitely the most amusing and witty. With the words trailing off to leave you wondering. The character in ‘Windjammer’ seems very carefully thought out by the poet but somehow unrealistic and over the top in his manner. You can’t help having a sneaking suspicion that for all his complaint, the author likes and respects the sea really. This is an actual similarity to ‘The Fringe of the Sea’ as the character here, is also very unrealistic, but for the opposite reason. Where, in ‘Windjammer’ the complaining character and seasick situation seems too bad, in ‘The Fringe of the Sea’ the gentle character and faultless situation seem too good.

The Beach Boys And California Mythology

The music of the Beach Boys during their peak creative period (1961-1967) is a key element in the â€Å"California myth,† which depicts the state’s culture as a youthful, exuberant paradise made possible by affluence, technology, and climate.It presents to the world in image of the state (particularly its southern coast) as an ideal place for the young to enjoy the climate, their freedom, and the benefits of an affluent society – an image that belied many of the region’s social realities and presented an appealing but ultimately distorted picture.The music itself has little intrinsically â€Å"Californian† about it. The vocals owe a great deal to white doo-wop from the late 1950s (particularly the intricate group harmonies), while the music derives heavily from that of Chuck Berry (indeed, â€Å"Surfin’ USA† is merely a blatant rewrite of Berry’s â€Å"Sweet Little Sixteen†). However, their lightness and upbeat, propulsiv e sound coupled nicely with Brian Wilson and Mike Love’s lyrics, which celebrated their own yearnings and their idealized vision of California culture.During their first six years of recording (before Brian Wilson’s mental illness became evident), the Beach Boys promoted southern California as a teenager’s paradise. Critic Jim Miller writes that, at their peak, the group â€Å"propagated their own variant on the American dream, painting a dazzling picture of beaches, parties and endless summers, a paradise of escape† and created â€Å"odes to affluent hedonism† (DeCurtis 192).Numerous songs depicted life there as a near-constant revel, in which teenagers had easy access to cars and thus to parties or the beach, where surfers dominated and one could find numerous opportunities for romance. The image of the sun-tanned, affluent, young white surfer spread internationally shaped perceptions of California throughout the world. The picture they presented repeated the same message – that California was a place where one could find pleasures unavailable elsewhere.Several of their songs, such as â€Å"409,† â€Å"Fun, Fun, Fun,† and â€Å"Little Deuce Coupe† (and more whimsically, â€Å"Little Old Lady from Pasadena†) exalt the automobile as a key component of their lifestyle; indeed, cars made the beach more accessible, accommodated dating and socializing, and liberated teenagers to a great degree. Furthermore, these cars had to be not simply serviceable, but also powerful and impressive; owning a hot rod was a status symbol in Beach Boys songs, giving one the most prestige and the most appeal to the opposite sex, as made evident in â€Å"I Get Around† (which combines cars, fun, and prestige in no uncertain terms).Regarding the opposite sex, their tunes celebrated California women as an ideal, attracted by fast cars or surfing prowess and blessed with good looks and warm, liberated personalit ies one could never find elsewhere. â€Å"California Girls† in particular spread the image of the young California as blonde, frequently found at the beach, and responsive to affluent male surfers with fast cars and status among their peers. They also helped make California synonymous with surfing, though one only one of the group (drummer Dennis Wilson) actually did it.â€Å"Surfin’ USA† and â€Å"Surfin’ Safari† depicted it as a nearly-ideal outdoor activity, which let one enjoy the mild climate, attract members of the opposite sex, and live in a hedonistic and relaxed atmosphere seemingly devoid of troubles or pressures. The affluence of the California they depicted made cars available, and, by extension, dating and fun impossible to find elsewhere, and the Beach Boys combined these in their material. Miller writes that â€Å"the group’s pursuit of fun, whether on a surfboard or in a car, set them apart and assured them . . .of an audien ce, no matter how restrictive the specific motifs, although surfing, cars, and the California locale all became emblematic† (DeCurtis 194). Though the Beach Boys’ material offered the promise of California as a virtual paradise of fast cars, status, and opportunities for romance, they neatly hid the broader realities of California life, creating the paradoxes that Rawls mentions. Most importantly, this vision did not apply to much of California, especially its northern half, a diverse region of mountains, urbanized areas, agriculture, and a much colder coastline.Also, the groups’ members hailed from blue-collar backgrounds, and the Wilson brothers (only one of whom actually surfed) came from a violent, hardly idyllic home. Their songs glorified not only a lifestyle that the group’s members generally did not practice, but it also celebrated a happiness that the troubled Brian Wilson could only yearn for, as well as eternal youth – an impossibility wh ich seemed less relevant as the members aged.It also managed to present a distorted picture of the Los Angeles region by focusing on a small class of young people. According to scholar Mike Davis, â€Å"It was the mesmerizing vision of a white kids’ car-and-surf-based Utopia† (Davis 66) that was generally not relevant to poorer youth or people of color. Their picture of California also excludes the region’s racial tensions; indeed, the Watts riots of 1965 erupted during this period, expressing realities that never figured in the Beach Boys’ music.The Beach Boys’ early music summed up California life as rooted in affluence and dependent on fast, flashy cars, which made leisure and attraction of the opposite sex possible. They presented an idealized and rather sanitized picture of a diverse, sometimes conflicted region. Indeed, class differences, racial tensions, and the more disturbing realities of the 1960s seem invisible, masked by the image of Ca lifornia as a place where one could have constant fun and revel in constant youth.Though they created a distorted, highly selective picture, the image remains potent to people outside the state and still colors many people’s perceptions of southern California. REFERENCES Davis, Mike. City of Quartz. New York: Vintage, 1992. DeCurtis, Anthony, James Henke, and Holly George-Warren, eds. The Rolling Stone Illustrated History of Rock & Roll. New York: Random House, 1992. Maasik, Sonia and Jack Solomon, eds. California Dreams and Realities. Boston: Bedford/St. Martin’s, 2004.

Hiv/Aids South Africa - 5278 Words

The HIV/AIDS Epidemic In South Africa Acquired Immune Deficiency Syndrome (AIDS) caused by the Human Immunodeficiency Virus (HIV) is one of many infectious diseases that plague the world today. According to the 2007 AIDS epidemic update put out by The United Nations Joint Program on HIV/AIDS (UNIADS) there were approximately 2.1 million AIDS related deaths and 33.2 million people infected with HIV world wide (UNAIDS/WHO Working Group, 2007). Despite its abundant resources and its well-developed financial sectors, South Africa has the largest HIV infected population in the world with approximately 5.7 million of its 44 million citizens living with HIV/AIDS (Global Health Facts, 2007). These 5.7 million cases alone account for over 28% of†¦show more content†¦During the attachment phase, HIV binds itself to a CD4 receptor sites on a CD4 + cell. Once this initial binding takes place, the virus then beings to bind with near by chemokine coreceptors which then bind with glycoproteins. These chemokine coreceptors and glycoproteins bound to the virus make up what is called a viral enveloped peptide. The viral enveloped peptide then fuses itself to the CD4+ cell releasing the virus inside the cell. Once the virus is inside the cell, it then releases two strands of viral RNA that then begins the process of reverse transcriptase within the cell. During reverse transcriptase, a mirror image of the single stranded viral RNA is produced and then fused together with its counterpart to make up double stranded viral DNA that can now infiltrate the nucleus of the infected CD4+ cell. Once the virus is inside the nucleus, it inserts itself into the infected CD4+ cells’ DNA so that it can begin the replication process. Transcription then takes place, transforming the double stranded virally infected DNA into single stranded messenger RNA (mRNA), that now contain the blueprint for the new viruses. 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Down Syndrome Association of Guam - Free Essay Example

Sample details Pages: 3 Words: 928 Downloads: 2 Date added: 2019/10/30 Category Medicine Essay Level High school Tags: Down Syndrome Essay Did you like this example? They offer a line of communication between educator, families, and individuals to resources available to assist those impacted by Down syndrome. The CEDDARS websites lists information to the following local organizations: Don’t waste time! Our writers will create an original "Down Syndrome Association of Guam" essay for you Create order Guam System for Assistive Technology (GSAT) Guam System for Assistive Technology or GSAT is a federally funded program under the University of Guam CEDDERS authorized under the Assistive Technology Act of 1998. GSAT provides assistive technology-related services to children and adults with disabilities in Guam so that they can live productive, independent, and quality lives. Guam Early Learning Council (Guam ELC) The Guam Early Learning Council was created to provide a coordinated framework, involving all child-serving agencies and family representatives, to develop a comprehensive system of supports for young children and their families. First established through Executive Order 2004-14 by former Governor Felix P. Camacho, and then mandated legislatively through Public Law 31-62 in 2011, the Councils composition, goals and objectives, and roles and responsibilities focus upon the efficient and effective delivery of services and support to young children, birth to eight (8), and their families. Guam Early Hearing Detection Intervention (Guam EHDI) This website is designed to provide information for families and professionals about the Guam EHDI Project, including infant hearing screening and the importance of follow-up screening, evaluation, and the early intervention services. Department of Public Health Social Services (DPHSS) Department of Integrated Services for Individuals with Disabilities (DISID) Guam Department of Education (DOE) The Guam Department of Education is a single unified school district consisting of grades Kindergarten through 12. Our 27 elementary schools, eight middle schools, five high schools and an alternative school serve over 30,000 students. Guam Department of Education (DOE), Division of Special Education The Guam Department of Education, Division of Special Education is committed to supporting all exceptional children and youth lead rich, active lives by participating as full members of their school and community. Guam Get Care Website An online directory and care coordination tool connecting the people of Guam to long-term care services and resources. Guam GetCare offers a territory-wide service directory to help consumers and their families quickly and easily access services. Guam Legal Services Disability Law Center Guam Special Olympics Special Olympics Guam (SOGU) is the major provider of sporting opportunities for people with a learning disability and provides equality of opportunity for all our athletes regardless of ability or degree of disability. Guma Mami, Inc. Guma Mamis mission is to facilitate the full inclusion and integration of adults with developmental disabilities and adults with serious mental illnesses into their communities through individual and family supports. The Guam Developmental Disabilities Council (Guam DDC) The philosophy of the DD Council is deeply based in the belief that persons with developmental disabilities have capabilities, competencies, and personal needs and preferences in common with all citizens. All individuals should be able to exercise control and choice in making decision that affect their life. Pripra Hao Pripra hao is a Chamorro phrase that means prepare yourself or get ready. In addition to general emergency preparedness planning, individuals with disabilities have additional needs before, during, and after an emergency situation that have to be included in their personal plan to ensure safety and allow for speedy recovery back to normalcy. Individuals with disabilities who are self-sufficient in normal circumstances may need the help of others during an emergency situation. These needs include, but are not limited to, medical treatment and medication plans, use of and relocation of assistive devices in the event of evacuation, appropriate transportation plans, and care of service animals. Root Cause Effects Many people with Down syndrome have grown to live independently, however this is not the case for Guam. In order for a person with Down syndrome to grow into an independent adult, the person must grow in a sufficiently stimulating environment as part of the growth process, and have access to proper medical care. In regards to environment many things play a roll in why people with Down syndrome on Guam are limited in being independent. Lack of proper stimulating environments in school prevent these younger and older individuals in elementary, middle and high school from optimizing on their abilities to learn. Culture also plays a large role in preventing them from being independent. Many families are unaware of the resources available to them, so they never enroll their special needs children in any programs that encourage autonomy in people with Down syndrome. From the looks of the demands of an individual with Down syndrome it can be very difficult for a person with Down syndrome to get proper medical care on Guam when the island lacks so many of these specialists. Prevention Methods *Finland or Sweden is trying to rid their country of Down syndrome by using early detection as a basis to abort a fetus with Down syndrome. This has been a highly controversial and offensive topic among the Down syndrome community. Although this is technically legal on Guam, and despite the early detection procedures being costly, there are currently no abortion doctors that are certified to perform the abortion on island. Conclusion In conclusion it is especially important for Guam to begin doing research on its own population to gather data that can contribute to improving national data about Down syndrome. This will include a needs assessment and comparison on the progress of programs in the United States to identify what may work here on island. It is equally as important to encourage medical professionals and specialists to be more available to assess and treat the needs of people of all age groups who are diagnosed with Down syndrome.