Peak Flow Essay Example | Topics and Well Written Essays - 1500 words

Peak Flow - Essay Example A spirometer is the equipment used in the measurement of peak flow. This apparatus measure the amount of air, which is taken in during inspiration phase and expired out over a specified time. Along with the amount, it also keeps a record of the speed, which is then converted to rate of air inspired and expired (Spirometer 2006) (Pederson 1996). Stating more scientifically, it measures lung functions specifically the measurement of the amount (volume) and /or speed (flow) of air that can be inhaled and exhaled. Spirometry is the process of measuring pulmonary function tests (PFTs) (Spirometry 2006). The process is an important monitoring tool for the diagnosis and prognosis of pulmonary obstructive diseases. Results are, usually, given as the percentages of predicted values for the patients of similar physiological characteristics. The results approaching 100 % predicted are the most normal but those individuals who show over 80% may be considered normal. The review by a medical doctor, further, validates the results (Spirometry 2006). ... All of the students present in the class (27) were involved in the process of data collection as subjects. To get more reliable calculations, the procedure of spriometry, has to be repeated three times per individual so every student went through the process thrice, each time followed by measurement of her/his height. For record of the reading and analytical purposes the highest value among all three is taken. To compare and reduce the possibility of error, two independent reviewers coordinated the experiment. We analysed these data at three different levels. Spirometry by the two reviewers was separated by various activities, like various phases forceful expiration, measurement of height etc. So we compared the highest readings from the two reviewers by applying paired t-test (Rosner 1995) (Saunder 1994). We divided the peak flow values in two categories, category 1 for lowest level to 540 and category to from 541 to the highest level. Then we looked for the association of the sex (1=female and 2=male) for the categories of the peak flow values. We applied chi-square test at this level(Rosner 1995) (Saunder 1994). As the two reviewers took part in the procedure as independent assessors so we analysed the level of agreement between the two reviewers by using Kappa statistics (Rosner 1995) (Saunder 1994). To fulfil the requirement of both variables to be categorical we managed the datasets to change the peak flow from continuous variable to the categorical variable. Results Table 1 shows the results of paired t-test performed to compare the mean values of two measurements of peak expiratory flow measured at two different time period with some activities performed in between. There was no difference found in the two values

Causes and Impacts of Rheumatoid Arthritis (RA)

Causes and Impacts of Rheumatoid Arthritis (RA) Rheumatoid Arthritis (RA) is a chronic, systemic and generally progressive disorder of unknown origin which affects connective tissues. RA is commonly manifested by inflammation of the synovial membrane of joints, immobility and general fatigue (1). Concurrent and symmetric polyarticular inflammation, which is its first clinical symptom, initially involves the small joints in the hands and feet (2). RA knows no geographical or racial boundaries and may occur at any stage of life. Its prevalence and incidence increases with age (3). According to other studies, its global prevalence rate is reported as 1% and such rate is the same worldwide (2, 4). According to the World Health Organizations 2002 annual report, RA accounts for 0.8% of total years lived with disability. Besides, the mortality rate of people affected is twice than that of general population at the same age. Also, the rate of its prevalence is significantly increasing in the recent years (2, 5). Furthermore, women are more likely to develop such disease than men as 70% of the patients suffering from RA are women. The disease, which mostly occurs in the fourth and fifth decades of life, can disrupt normal daily activities (2, 6). RA may cause numerous physical complications among which chronic pain, fatigue, impaired mobility and limb deformities are the major ones (7). RA-induced complications are not limited to apparent limitations in mobility and activities of daily living; but obscure systemic effects of such disease can also lead to organ failure, death or serious health problems such as pain, fatigue, sleep disturbance and changes in self-image. Such complications can cause disabilities and permanent changes in the patients (8). The chronic nature of rheumatic diseases necessitates obtaining the required knowledge about the disease to make sound decisions for managing the health condition and developing a treatment plan tailored to the patients lifestyle. Fundamental objectives and strategies to deal with such diseases includesuppressing inflammation and autoimmune response, controlling pain, maintaining or improving joint mobility and functional status as well as increasing the patients’ awareness of the disease process (8). Encouraging patients to adopt correct and proper self-care behaviors is an important factor which contributes to successful management of the disease (9). Self-efficacy also seems extremely important in managing RA.Unpredictable courses of the disease and its varying activity can make the patients find their disease uncontrollable which, in its own turn, can decrease their self-efficacy in managing it (10). Self-efficacy is a form of self-confidence defined as ones belief in ones own ability to successfully organize and accomplish a particular task, behavior or any changes in cognitive status regardless of the underlying terms and conditions (11, 12). It is also a prerequisite for behavior change which affects the amount of efforts and level of performance (13). People with higher levels of self-efficacy hold a belief that they are able to control their life events effectively. Such perception and belief, which can affect their behaviors directly, create a standpoint for them different from that of people with poor self-efficacy (11). Hence, self-efficacy is a critical factorcontributing to the success and failure of people throughout their lives. Individuals’ perceptions of such sense, is the most powerful predictor of their ability to change risky behaviors. It also determines how they face obstacles and difficulties. The people with low self-efficacy are easily convinced that their attempts are useless so they quickly stop striving. However, those with high self-efficacy not only can remove the barriers by improving self-management skills and persistence, but they also can stand against problems and have more control over their affairs. Besides, reinforcing self-efficacy can result in maintaining and preserving health-promoting behaviors (14). Its significant role in the initiation and maintenance of healthy behaviors,in case of occurrence of any disease such as arthritis, asthma and diabetes mellitus occurs, has been frequently reported by researchers (15). Previous studies have shown that using structured education can improve it in patients suffering from chronic obstructive pulmonary disease as well (16). It is also reported that increased self-efficacy could improve self-care skills and behaviors in the patients with diabetes mellitus (17). The evidence show that it is essential to enable the patients to take care of themselves using scheduled training programs, which are based on patient-centered approaches, including patients’ active participation in improving their quality of life.It is of extreme importance due to several reasons such as priority of prevention to treatment, the chronicity of the disease, shorter hospital stay and spending recovery period at home as well as the problems of access to health care (18-20). Atak et al (2010) reported the significant effect of education and subgroups of regular exercise, choosing healthy diet and controlling complications of the disease on the mean of total self-efficacy scores in the patients with diabetes mellitus (21). Furthermore, the results of another study revealed that education could significantly affect perceived self-efficacy in the patients with arthritis with respect to their ability to exert control over pain; however, it was not significant in terms of shin-related exercises. The researchers justified the lack of educational effects on exercise-related self-efficacy by explaining that training in a limited period of time cannot enhance the patients’ confidence in taking such action due to severe complications such as joint stiffness, pain and inflammation they experienced (22).Ø ªÃƒÅ¡Ã‚ ©ÃƒËœÃ‚ ±ÃƒËœÃ‚ §ÃƒËœÃ‚ ±Ãƒâ€ºÃ…’ Vikery et al conducted a similar study to examine the effect of self-care trainings on disease outcomes. The obtained results showed that self-care training could decrease morbidity, the number of medical visits required and consequently healthcare costs (23). Even a small percentage increase in the self-care of chronic conditions can have major effects on reducing the demand for specialized services in health care (24). Patrich (2008) believe that without training the patients and their participation in their self-care process, health care will be more costly and quality of life will be more impaired (25).Patient training is a vital aspect of nursing care for those with arthritis to enable them to live as independently as possible, take their medications correctly and safely and use assistive devices properly. Such training is focused on the type of disorder, possible changes resulting from the disorder, prescribed treatment regimen, side effects of the medications and strategies to maintain individuals’ independence and performance as well as patients safety at home (8). Several studies showed that training the patients can raise their knowledge and result in the improvement of self-management activities and health status so that they can prepare themselves for decision-making and compliance with the treatment regimen (26). It is worth mentioning that the aim of training the patients with chronic diseases is to sustain their behavior change for a longer period of time and even until the end of life.Due to the nature of the disease, immediate changesare not expected to be seen; for example prompt resolution of disabilities and difficulties is not expected to occur in case of chronic diseases such as arthritis. However, self-management training seems essential and profitable; so, the patients should obtain required knowledge and skills needed for decision-making and solving their own problems and those related to communicating with others (27).

Richard Wagner :: essays research papers

Richard Wilhelm Wagner Richard Wagner was born in Leipzig, Germany, on May 22, 1813. His work was done throughout the romantic period. His father died soon after his birth, and in 1814 the family moved to Dresden. In 1822 Wagner entered Dresden's Kreuzschule. In 1828 he enrolled at the Nicolaischule in Leipzig, where he began lessons in harmony with the conductor named Christian Gottlieb Mà ¼ller. Over the next three years he composed several piano sonatas, overtures, and seven songs. Inspired by the works of Beethoven, Mozart, and Weber and Shakespeare, Goethe, and Schiller, he taught himself piano and composition. He entered the University of Leipzig. There he lived wildly but he seriously paid attention to composition. His 'Symphony in C' was performed in Prague in 1832 and the following year it was played in Leipzig. The next six years he spent as a conductor at low class local theaters. In 1836 he married the actress Minna Planer, and in 1839, they left for Paris. Living with poor German artists, Wagner wrote musical journalism and did cut work. But in 1840 he completed â€Å"Rienzi†, his first major opera. It was successfully produced at Dresden in 1842 and resulted in his slot as musical director of the Saxon court. Here â€Å"The Flying Dutchman† was produced in 1843, and â€Å"Tannhà ¤user† was completed in 1845. These operas were much criticized, because they lacked the melodies of the popular operas. Wagner took part in the German political revolt of 1848-1849 and was forced to leave the country. For about ten years he lived in Zà ¼rich, Switzerland. In 1864 King Ludwig II of Bavaria invited him to continue his musical work in Munich. During the years in Munich, he completed â€Å"The Ring of the Nibelung† which was a series of operas based on old German myths that he had begun in Zà ¼rich. The opera house in Munich was too small for these great operas. Wagner suggested that a theater be built from his own designs. The king approved the project, and the outcome was the famous Wagnerian Festival Theater in Bayreuth, Bavaria.

Mary Shelley present Frankenstein Essay

‘Frankenstein’ was written in 1812 by a woman called Mary Shelley, at the age of 19, this shows that she is very intelligent because to write such a novel with so much understanding at a very young age shows that she was a dedicated female author who studied very hard. At first when I heard of the novel ‘Frankenstein’ I straight away thought without any doubt that it was a man who wrote this novel, because firstly it was a horror story so that instantly clicked in my mind to think that it was a man but I was very shocked to find out that the author of the novel was actually a women. This seemed very unusual to me because firstly at that time female authors were less well thought of than male authors and also even if female writers wrote books you would expect them to be all flowery and cosy type but for a women to write a novel with such imagination, creativity and devilish thoughts seemed very unusual with the basic fact that she was a women. This again showed that she was very intelligent. She also didn’t put her name on the book for 13 years, this was because of the fact that mentioned earlier about female writers being less thought of than male writers. I believe that she done this because during that time there might have been a lot of sexism and she believed that if she put her name on the book than a lot of people may not have bought it because she was a female and when she did put her name on the book I am sure that a lot of people were shocked to hear that it was written by a women. She probably played a vital part in raising the confidence of female writers and broke the deadlock for all female authors. The novel was about a young ambitious scientist who is keen to prove that he can create life. The scientists name is Victor Frankenstein. He accomplished his mission but all his dreams about this being were crushed when he realised what a monster he had created. Frankenstein ran away from the monster and left it to a life of loneliness. The monster learned how to talk and read and soon tracked down Victor Frankenstein. After being treated badly by humans the monster had one thing on his mind which was revenge. The novel starts with a letter from Robert Walton an explorer, to his sister. He is preparing to go on his way to his desired destination the North Pole. He is a very ambitious man and he wants to go on this expedition because no man has ever set foot there. Walton writes: â€Å"Never before imprinted by the foot of man† Walton also wants to be the man who discovers the route to the North Pole because at that time there was no route to this area of the world. This shows how desperate he was to go there and his ambitiousness. He trained his body for the expedition and Walton tells us: ‘I voluntarily endured cold, famine, thirst and of want of sleep’ This proves his determination and how serious he was about his venture.

The Palace of Versailles and Contemporary Art: Takashi Murakami

The Palace of Versailles located approximately twelve miles outside Paris, France and is viewed as a place to showcase modern art. Much of the art that the palace has put on exhibitions over the years has brought a lot of controversy including the most recent one by Japanese artist Takashi Murakimi. Looking back at the 400 years of history at the Palace of Versailles it was once a home for the French royal family, a center for political power and today is a symbol of absolute monarchy. King Louis XIV viewed Versailles also as a showcase for the artists he supported. Louis and his successors were passionate about contemporary art and were constantly having parts of the palace demolished and rebuilt and redecorated by the newest and finest artists of their day. Versailles serves as a place where the newest ideas in art are showcased and served as a trendsetter for other palaces as well such as The Louvre; with it’s over the top decorations showing the monarchy’s wealth. Today, the palace is constantly having some of the currently most popular artists showcase their work at Versailles for the public to view. The most recent exhibit at the palace by Takashi Murakami ran from September 14, 2010 to December 12, 2010 has sparked a lot of controversy. This exhibition is called Murakami Versailles features 15 statues placed in different rooms of the palace. Murakami is a contemporary artist from Japan and has been billed as the new Andy Warhol, who is also Murakami’s mentor. The showcase features big, brightly colored cartoonish figures, flowers, globes and other inanimate objects. The style is far from the Baroque style of the palace, leaving most critics to deem the show inappropriate. Some groups visiting the Chateau complained that Murakami’s work has no place in rooms once residence to historical figures such as King Louis XIV, France’s Sun King and Marie Antoinette. Prince Charles-Emmanual de Bourbon-Parme, an heir of Louis XIV, tried to get the exhibit banned stating that it dishonored his family and their past but the courts dismissed his bid. One of his most tasteless pieces is a sculpture titled Hiropon, a large-breasted girl in a bikini who is skipping through a â€Å"rope† made of breast milk, this piece is not included in the exposition but it shows that Mr. Murakami is undeserving of Versailles. Muarakami spoke at a news conference and discussed the controversy. â€Å"When I hear such things, I say to myself that when a (sports) team scores a goal, there are always people who aren’t happy about it and who express that discontent†¦ The exhibit’s meant to be a sort of face-off between the Baroque period and postwar Japan, and I hope it will create in visitors a sort of shock, an aesthetic feeling† (Barchfield). Jean-Jacques Aillagon, president of the Chateau de Versailles defended the showcase saying he believes it is â€Å"‘his duty to open the palace to the artistic creation of our times’† (Barchfield). He also stated it gives the â€Å"visitors to historic monuments the chance to discover art that is less familiar to them† He added that the protests â€Å"come from far-right fundamentalists circles and from very conservative circles who see the museum as a reliquary of nostalgia of Ancient Regime France, of a France, that is turned in itself and hostile to modernity† (â€Å"Protesters†). Aillagon also stated â€Å"the palace and Murakami’s work are both joyful- the palace was not a place of penitence, not a place to be sad† (â€Å"Takashi Murakami's Versailles†). Versailles curator, Laurent Le Bon, stated â€Å"most of the visitors come for the chateau, not for Murakami, and are unfamiliar with contemporary art† (Von Uthmann). Several online petitions gathered thousands of names online even before the exhibition opened to the public. Two years ago a similar controversy occurred when Aillagon brought in contemporary American artist Jeff Koons. Call me a far right fundamentalist and conservative but I agree with all of the criticism surrounding this issue. This past November I got the privilege of traveling to Paris and visiting the Palace of Versailles. I had not heard anything about this exhibit occurring until getting to the Palace, walking into one of the first rooms and seeing it firsthand. I was appalled when seeing the first statue, my family and I thought the statues took a lot away from the beauty of the chateau. It also prevented us from seeing parts of the rooms and taking pictures of ceilings, walls, specific architecture that was being blocked from the statues. One visitor stated â€Å"[w]e are in a historic place, we want to see how history happened here, but every time you see a doll or a crazy monster it takes you completely out of the climax of the place† (â€Å"Takashi Murakami's Versailles†). Another stated, â€Å" it totally detracts from everything that’s here. It’s almost insulting to the palace and to visitors† (â€Å"Takashi Murakami's Versailles †) My least favorite was a piece called Tongari-Kun, also known as Mr. Pointy, inside one of the state rooms because it was so tall it blocked me from seeing the entire ceiling. Moreover, another piece called Flower Matango in the Hall of Mirrors was just awful in this room. The hall of mirrors is one of the most famous and beautiful rooms in the entire palace rich in beauty and history but it was all masked because of this statue. The sculpture of a bunch of bright, animated, ugly flowers. We could not step back and see the entire hall in its original beauty without seeing this statue smack in the center and the beauty of the mirrors was taken away because this statue was being reflected off of almost every one at that end of the hall. The statues were too brightly colored and too in your face from the mood of the rest of the palace. I have no personal pictures of the artwork because I, along with everyone else in my family, made sure Murakami’s art was out of every picture frame. I can understand why they have the exposition and the cultural exchange, the fact that they want to keep the tradition of showing the world modern art but unlike when the palace was being used for residence and power today the palace is an enormous historical landmark and is visited by over three million people per year. People do not go to the Parthenon in Greece or the Colosseum in Rome to see other artists or even have other artists intruding on its beauty. Likewise, these visitors do not go to see modern art but to see the old beauty of the palace and walk into a bit of history for a day. There are so many other museums in Paris that show modern art that the Palace of Versailles does not need to be one of them. The Palace is a piece of art on its own and does not need to have these controversial exhibits constantly demolishing its beauty. After seeing this overall I was disappointed with the exhibit and I wish I could go back another time when there will not be such a distraction.