A critical analysis of a patient's journey through Paediatric Essay

A critical analysis of a patient's journey through Paediatric Intensive Care Unit from a nursing perspective - Essay Example Even with the children who suffer the extreme form of this heart defect. The success rate has been very encouraging. The said infant suffered from Hypoplastic left heart syndrome (HLHS) which is an extension of congenital heart disease. It is the fourth most common type of congenital cardiac defect. It basically is a functional signal ventricle due to the congenital heart. HLHS is characterized by a multiple abnormalities related to heart including steosis or atresia of ventricular  inflow and outflow tracts of both the left side (Report of the New England Regional Infant Cardiac Program, 1980). In the 1980’s most of the infants died within the first month of their birth but since then due to various medical advancements and the advent of Norwood procedure, the survival rate has risen a great deal (Kirklin et al. 1980). The two treatments of the congenital heart being currently offered are either multi stages surgical palliation or the orthotopic cardiac transplantation. The mortality rate of the HLHS is considerably higher than other defects occurring due to the congenital heart disease. Additionally there is not much knowledge and information about the long-term follow-up related to the HLHS survivors (Caplan et al. 1996). The infants who are born with this disease are usually born on time and have relatively normal birth weight. It has also been researched that extra cardiac and malformationsare is present in about 2.3% of them (Report of the New England Regional Infant Cardiac Program). It has also been noticed that its occurrence is more in boys than in girls. Fortunately the chances of this disease being present in the siblings are only 0.5% of the times and only 2.2% for other extension of congenital heart disease (Wernovsky, Bove, 1998). The chances of survival post the cardinal surgery has been increased to 95% now. Unfortunately the exact cause of the HLHS has yet

DiscussionAnalyzing Cost of Capital Essay Example | Topics and Well Written Essays - 250 words

DiscussionAnalyzing Cost of Capital - Essay Example In order to reduce this and attain an optimum capital structure the firm needs to determine the combinations of equity and debt that minimize the W.A.C.C. The effective use of that capital should also be considered, as there would be no need of accumulating large amounts of capital without necessary considerations of the projects that are supposed to be undertaken. The company should also consider the cost of raising the particular capital that it deems appropriate. This is measured by the marginal cost of capital. . To obtain finance a company will pay implicit costs which are commonly known as floatation costs (Rosemary, 2012). These include: Underwriting commission, Brokerage costs, cost of printing a prospectus, Commission costs, legal fees, audit costs, cost of printing share certificates, advertising costs etc. For debt there are legal fees, valuation costs (i.e. security, audit fees, Bankers commission etc.). The company needs to determine the combination of capital items that will minimize to a large extent the marginal cost of capital (M.C.C). The company also needs to consider leverage. This is the amount of debt used to finance a firm’s assets. A firm with significantly more debt than equity is considered to be more leveraged. A high degree of leverage increases the financial risk the company faces, as it may not be able to refinance such debt, leading to insolvency (Rosemary, 2012). An optimum capital structure needs has lower amounts of financial risk and sustainable levels of

Wind Stability Engineering in High Rise Buildings

Wind Stability Engineering in High Rise Buildings In building construction, there is a reciprocal relationship between forces within and external to the structure that directly affect stability and longevity. Fundamentally, damped oscillations operate within a system where a resistance (oftentimes passive) is applied to the structure in direct conflict with the natural or imposed oscillation, thereby stopping the movement (Knight, 2007).   Forced oscillations also act upon a structure as harmonic resonance is neared. In such systems, there is a natural oscillating frequency (number of oscillations completed per second) which operates within the structure, and an external force termed the driving frequency which acts upon the system. Large differences between these two forces do not actively define the amplitude of the oscillations; however, when they are numerically equal to each other, harmonic resonance results, highlighting the maximum amplitude of the system (Knight, 2007). Damped systems utilise force to reduce the affect of oscillations on structural integrity, thereby preserving the lifecycle of the building. To design and appropriately calculate the functions of a damped harmonic oscillator, the following components are needed where is equal to a constant and is equal to the structural mass. This formula represents several functions of the structural stability including where in which a critically damped case arises and equilibrium is quickly established; where the system is over-damped and equilibrium is slowly reached; and where the system is under-damped and exhibiting transient behaviour (Elert, 2007). Perhaps the most famous example of harmonic resonance leading to structural deformation, the Tacoma Narrows Suspension Bridge in the United States has been oft studied by scientists and scholars to determine the forced collapse. The product of a galloping oscillation, this structure was subjected to high wind forces (35mph) which excited the bridge’s transverse vibration mode, resulting in three hours of motion with an amplitude of 1.5 feet (Irvine, 1999). A supplemental increase in wind to 42 miles per hour caused dampening cables to snap, resulting in an unbalanced load condition that increased the amplitude to 28 feet, and ultimately ended in collapse (Irvine, 1999). More modern examples of structures functioning under the support of dampers include Victory Monument on Poklyonnaya Hill in Russia which features three dynamic oscillation dampers, fifteen flexural oscillation dampers, and one torsional oscillation damper (â€Å"High-Rise Constructions,† 2008). Represent ative of a system utilising both active and passive damping forces to reduce structural vibrations, this structure rises 141.8 m and retains a skeletal framework of steel latticework, requiring the enhanced oscillation damping. In high rise building construction, oscillations due to wind forces acting in both linear and non-linear capacities directly contribute to structural instability. Etkin and Hansen (1984) note that within such systems, artificial dampers limit the motions and resulting stresses and through a determination of the amplitude of response consistent with wind related variables, predictive measures can identify the maximum reaction. Similar forces directly contribute to structural destabilisation, undermining integrity through resonance and incumbent force variables. In 1994 a crane in Germany demonstrated the influence of galloping induced oscillations as it was destroyed by fatigue cracks in the tension bars during the bending mode at resting state (Hortmanns and Ruscheweyh, 1997). Resulting from wind based forces in a state of quasi-stationary vibrations, such structural conflicts oftentimes occur in large scale construction applications and cylindrical structures (Hortmanns and Ruschewe yh, 1997). Theoretical investigation of multiple vector damped linear systems has determined that resonant modes are free of coupling due to the damping forces, causing the system to behave as a sum of independent one-dimensional subsystems (Mathieu, 1965). The initial formulaic calculation for such a system is as follows: When coupled with Raleigh’s assumption of proportion between stiffness and damping, this formula enables multiple variable calculations within a linear system that are mathematically independent of system counterparts (Mathieu, 1965). Effective in determining the relationship between frequency and harmonic balance at differing segments as well as varied temporal intervals, this equation is one more step towards comprehensive structural analysis. Considering that high rise structures demonstrate an incidence of wind-generated harmonic flux as well as torsional sinusoidal wave vibrations based on innate building oscillations, calculating amplitude at varied temporal positions offers long term predictions of stability and maximum collapse potential (Katagiri et al., 2001). The preceding sections demonstrate the innate relationship between harmonic resonance and the forces which act both internally and externally to a structure. Ultimately, resistance is derived through damped systems or a forced resonance, thereby counteracting the effects of wind, torsional movement, and ground shifting. More modern investigation into differentials between linear and non-linear systems as exemplified by exploiting Raleigh’s formulae in Mathieu demonstrate that variables within the resonant system oftentimes operate individually, thereby prescribing unique forces without concurrent incidence within counterparts. Long term implications of such predictive mechanisms include dynamic damping integration which acts on a sector basis to minimise torsion. References Elert, G. (2007) The Chaos Hypertextbook. Glenn Ellert. Accessed on 29/11/08 From: http://hypertextbook.com/chaos/41.shtml. Etkin, B; Hansen, J.S. (1984) â€Å"Effect of a Damper on the Wind-Induced Oscillations of a Tall Mast.† Journal of Wind Engineering and Industrial Aerodynamics, Vol. 17, pp. 11-29. â€Å"High Rise Constructions.† (2008) Melnikov Institute. Accessed on 29/11/08 From: http://www.stako.ru/show_prj_list.php?id=arch_highlang=engdata=arch_highprn=yes. Hortmanns, M; Ruscheweyh, H. (1997) â€Å"Development of a Method for Calculating Galloping Amplitudes Considering Nonlinear Aerodynamic Coefficients Measured with the Forced Oscillation Method.† Journal of Wind Engineering and Industrial Aerodynamics, Vol. 69, pp. 251-261. Irvine, T. (1999) â€Å"The Tacoma Narrows Bridge Failure.† December. Accessed on 29/11/08 From: http://www.vibrationdata.com/Tacoma.htm. Katagiri, J; Ohkuma, T; Marikawa, H. (2001) â€Å"Motion Induced Wind Forces Acting on Rectangular High-Rise Buildings with Side Ratio of 2.† Journal of Wind Engineering and Industrial Dynamics, Vol. 89, pp. 1421-1432. Knight, R.D. (2007) Physics for Scientists and Engineers. New York: Pearson Education. Mathieu, J.P. (1965) â€Å"On Damped Vibration Theory.† International Journal of Mechanical Science, Vol. 7, pp. 173-182.

China Between The Fall Of The Kmt And Mao Tse-tungs Death :: essays research papers

China Between The Fall Of The KMT and Mao Tse-Tung's Death The time from 1949-1976 was a time of transition for China. Many social and economic changes occurred through this period. When the Kuomintang government collapsed and Mao Tse-Tung assumed control, this marked the beginning of massive reformation for what would become the People's Republic. With Mao Tse-Tung's rule came governmental reform which led to social betterment. His first years of rule included careful development and reorganization backed by Soviet support. The landlord class was wiped out with the nationwide land reform and the land was divided among the peasantry. Equality prevailed for women and attacks where made on official corruption. Efforts were made to improve sanitation and literacy among the people. These changes generated patriotism during China's involvement in the Korean War. While social reforms proved to be beneficial to China, attempts for industrial and agricultural growth were not as successful. From 1953-57 industrial production was expanded and agriculture was collectivized. But disappointing agricultural production led to the frenzied Great Leap Forward of 1958-60. This program, initiated by Mao, was designed to step up industrial production to a level with Britain and create a truly communal society without Russia's aid; all in the course of 15 years. The project was a failure and Liu Shao-Ch'i temporarily took over Mao's position as head of state. When differences between party leaders arose, and Mao Tse-Tung began feeling that the revolution was exhausted, he launched the Cultural Revolution of 1966-69. This was intended to stir up the conservative government/military and add more revolutionary elements, ridding the nation of the 'four olds': old ideas, old culture, old customs, and old habits. These revolutions often turned into violent acts. When stability was restored, foreign relations was

“An Occurrence At Owl Creek Bridge” By Ambrose Bierce Essay

Naturalism is often perceived as a form of writing which is blunt because of the candor that writers used in approaching the subject. However, while naturalism is known to employ detailed realism in describing its subjects it necessarily follows that characterization becomes a critical process where the reader is given the benefit of making a conclusion as to how a particular character is characterized. In effect, naturalism merely generates the facts for the reader to base his/her conclusion on. In this light, the main character in Ambrose Bierce short story, â€Å"An Occurrence at Owl Creek Bridge†, Peyton Furquhar is given flesh and blood using naturalist elements of description, association, and flash back. Description is a device that could be perceived as naturalist because it is through this that the writer is able to give a matter-of-factly picture of the character and in the short story, such device works to initially present the superficial characteristics of the main character. For instance, in the line, â€Å"Peyton Farquhar was a well-to-do planter, of an old and highly respected Alabama family. † (Bierce, 2010) no further suppositions can be made except for what is being stated; that the protagonist is well to do, is in agriculture, and has integrity in that he is a well respected member of a known family. Obviously, in these lines, the writer does not have any intention of creating other subjective interpretations; instead he simply states what is superficially apparent. In another line from the story, â€Å"her husband approached the dusty horseman and inquired eagerly for news from the front. † (Bierce, 2010) still referring to the protagonist, the author again reveals another superficial personality that being the eagerness of the protagonist for news, in fact this particular characterization is stated in the same line to avoid further misjudgments. Association is also used in the story to indirectly characterize the character by revealing apparent unrelated events or situations. This is consistent with naturalism where the environment and social circumstances can work to influence a particular character or an event. In the lines, â€Å"Evidently this was no vulgar assassin. The liberal military code makes provision for hanging many kinds of persons, and gentlemen are not excluded. † (Bierce, 2010) succeeding a lengthy description of the physical attributes of the protagonist, the writer, by association, suggests that the protagonist was being executed unjustly. Further analysis of this line would reveal that another association comes to mind; that the character belongs to the middle or the upper class. So, even without the physical descriptions, one can easily associate the mitigating circumstances to the actual character of the protagonist. Another such example is found in the lines, â€Å"To be hanged and drowned,† he thought? â€Å"that is not so bad; but I do not wish to be shot. No; I will not be shot; that is not fair. † (Bierce, 2010) here, the author reveals a side to the character of the protagonist determined by his chosen method of death – being shot during this period was an undignified way of dying as it was indicative of the gravity of the fault of the one being executed. Shooting was also done while the victim had his back on the shooters which all the more makes it quite humiliating and degrading. So, this particular line characterizes the protagonist, through external circumstances, as someone who has a reputation that he protects and would not want to be tarnished. Other than just association, reminiscing and flash back are also tools in naturalism that may be employed to characterize a character. Flash back is when the protagonist draws from past experiences or recalls certain social elements that are not in effect at the period the story is being told, and these elements can reveal much about the character and even affirm the actions of the character. So, in the lines, â€Å"By diving I could evade the bullets and, swimming vigorously, reach the bank, take to the woods and get away home. My home, thank God, is as yet outside their lines; my wife and little ones are still beyond the invader’s farthest advance. † (Bierce, 2010) the author paints the character to be someone who is deeply concerned of his family that even in his direst moments, as guards were shooting at him from the riverbank, he still had thoughts of his home intact, which he verily recalled consequently revealing this particular aspect of his personality. Again, this same naturalistic device is used in the lines, â€Å"He must have traveled the entire night. As he pushes open the gate and passes up the wide white walk, he sees a flutter of female garments; his wife, looking fresh and cool and sweet, steps down from the veranda to meet him. †; (Bierce, 2010) where a sexual nature is revealed in the scenes that the protagonist recalls. Here, other than just revealing that the character is a homely and family person, the stark description of the garments as well as the scent of the wife are consistent with a subliminal description which points to the sexual desires of the character. In the story, â€Å"An Occurrence at Owl Creek Bridge† Bierce effectively gives his character ‘life’ notwithstanding his turning up dead in the end, by using certain elements of naturalist and realist literature. Here one sees that through superficial and candid description, association of environmental and social circumstances, as well as the recall or reminiscing of past circumstances, the personality, attitude, and character of the protagonist becomes more vivid and believable. References Bierce, A. (2010). An Occurrence at Owl Creek Bridge. Retrieved May 5, 2010, from http://fiction. eserver. org/short/occurrence_at_owl_creek. html

Civil War Position Paper Essay

The American Civil War almost tore early America and its population apart. Still today people debate weather slavery was the primary cause for the war. In this paper I will explain why I believe slavery was not the primary cause of the American Civil War. Also I will point out many other factors that may have played a bigger role in the cause of the Civil War. Southern states believed STRONGLY in states’ rights. States’ rights are the belief that one should be loyal to their state instead of the country as a whole, also they believed that states should be able to make their own laws to their liking without having to answer to the country. This alone created tension between the southern states and the northern states for northern states felt that the constitution clearly stated that states can create laws as long as they do not conflict with the laws of the country. In addition to the tension between the north and south congress placed a tax on goods bought outside of the country otherwise known as tariffs. In 1828 and 1832, congress raised tariffs higher and higher. These taxes were hated by the southern states for they did not have many factories unlike they’re northern counterparts, and thus they paid tariffs more often. In one instance a southern state refused to pay the tariff nullifying the tax congress had placed this event known as the nullification crisis drove the wedge between the north and south further The bloody fighting between northern and southern voters in Kansas was another step in the path of the civil war. Due to the popular sovereignty act suggested by Senator Stephen Douglas the people where able to vote on whether that territory would’ve been a free state or a slave state, this caused voters from both the north and the south to pour into these states hoping to tip the scale in their favor in doing this conflict between the two erupted as homes were burned and people were murdered. In conclusion I do not believe that slavery was the primary cause of the civil war. My reason for thinking this is because of all the events that the country had to push though on top of slavery. For starters states rights, tariffs, nullification crisis, the Kansas Nebraska act, and the bleeding Kansas scare all played a bigger part in the cause of the civil war rather then slavery.