Ted.com Essay Example | Topics and Well Written Essays - 500 words

Ted.com - Essay Example This led Maskowitz to eventually determine that rather than developing a singular product, companies must develop a series of variations on this product to appeal to a broad range of people. The video goes into relay when Prego asked Maskowitz to help them develop a sounder product. Maskowitz responded by developing a multi-differentiated product line. Rather than attempting to determine the most popular spaghetti sauces among this group, Maskowitz worked to determine the groupings for form that would be the most popular. It was ultimately determined that extra-chunky was one of the popular types of spaghetti sauce that had not been developed yet had considerable public demand. Prego would release this brand and go on to net over $600 million dollars over the next decade. The main point Gladwell is making is that rather looking for universal answers, companies must consider human variability when designing products. Seth Godin on standing out As my major is finance and marketing, I c hose a video on marketing referred to as Seth Godin on standing out. Seth Godin is a recognized entrepreneur and blogger, and is greatly concerned with marketing in the digital age. This particular video considers ways that individuals can stand out in the contemporary marketing world.

Proportion Paper Essay Example | Topics and Well Written Essays - 750 words

Proportion Paper - Essay Example for a proportion, sample size required for a proportion, confidence interval for the difference of two proportion, comparison of a proportion with hypothesized proportion, and comparison of two proportions will be discussed. Central Limit Theorem (CLT) for a Proportion state that â€Å"As sample size increases, the distribution of the sample proportion p = x/n approaches a normal distribution with mean Ï€ and standard deviation.† The statistic p = x/n is assumed normally distributed when the sample is large. A conservative rule of thumb that normality may be assumed whenever nÏ€ ≠¥ 10 and n(1 − Ï€) ≠¥ 10. This rule requires a very large sample size to assume normality when Ï€ differs greatly from 0.50 (Doane & Seward 2007). Using the Central Limit Theorem, the probability that a sample proportion will fall within a given interval can be stated. The confidence interval for a population proportion, Ï€ at a given confidence level (1 – ÃŽ ±) is given by The value of z can be obtained using normal table (Z table) or using Excel function NORMINV(ÃŽ ±/2). The width of the confidence interval for a population proportion, Ï€ depends on the sample size, confidence level (1 – ÃŽ ±), and the sample proportion p. The estimate of difference and standard deviation of two-population proportion can be given by and , respectively. Using this estimate, a confidence interval for the difference of two population proportions, (Ï€1− Ï€2), is given by For normal sampling distribution, the test statistic for the hypothesis test will be z score. This test statistic is compared with critical value of z score at the selected level of significance, ÃŽ ± for retaining or rejecting null hypothesis (H0). The test statistic for a population proportion with hypothesized proportion Ï€0 is the difference between the sample proportion p and the hypothesized proportion Ï€0 divided by the estimated standard error of the proportion (denoted ÏÆ'p) as given below The assumptions of comparison

Malcolm X and Black Nationalism Essay Example | Topics and Well Written Essays - 750 words

Malcolm X and Black Nationalism - Essay Example Due to such mistreatment of blacks they became tired and needed a forum to express their challenges. This led to the formation of civil right movement that promoted equal education and legal rights. Despite the two being vocal in the Black Nationalism in USA, their views differed (Cone et al, 2003). MLK comes from a very affluent family and Malcolm X from a poor background, therefore the basis of argument are different in that MLX called for a Non –violent resistance for example the triumph of the Montgomery bus (1955) in Alabama whereas Malcolm X is viewed to be violent ‘By all means† Most blacks, like such as Malcolm X, MLK methods were useless and lacked basis. But, King continually emphasized in nonviolent approach. He refuses to inflict physical harm on others. According to Dr. King, he argues that nonviolence methods resist evil, and it refuses to commit evil. He continues by saying that the enemy is a person and must be treated fairly; one should not destroy the rival but rather seeks to make the foe a friend. Even if using violence fails to convert the foe to a friend; it removes hatred from the hearts of those who are committed to it.† Violence was very impractical and immoral (Waldschmidt, et, al, 2003) According to Malcolm X, he did not favor integrations of white and blacks; he even continues to warn the blacks of integrating with ‘sinking ship’. Therefore, he emphasized on black separatism and not integration. Dr. King advocated for unity and peaceful coexistence among individual of different races (Cone et al, 2003) . The different in ideas originate from the environment that one was bought in. King was brought up in a religious environment and their parents who loved unity. Unlike Malcolm X, the ideas originated from the racial hate that killed his father who influenced him in Black Nationalism activism. Moreover, he was subjected to white violence and racism, and this made him drop out of school

Language Assessment Principles Essay Example | Topics and Well Written Essays - 1000 words - 4

Language Assessment Principles - Essay Example other words, this meant viewing as a student rather than as a teacher. Only after I understood what the student was seeing could I understand what would benefit the student, and therefore provide the necessary means of delivering that lesson. It basically allowed me to assess him based on what was challenging to him as a learner who was struggling to understand the language, rather than as the student of someone who was very fluent in the language. Another misconception I quickly became aware of was that I had always thought assessment was purely for the benefit of the student. While this is partially true, in an indirect way, assessment of a student can also greatly benefit the teacher. In fact, for a good teacher the assessment of a student is vital because through assessing the student, one is able to assess himself as a teacher, possibly better than he could through any other method. When a student struggles with certain aspects of language, but cannot point out exactly where ass essment helps to narrow it down and give information of which areas need more practice and which areas the student is weak in. This allowed me, as a teacher, to focus on those areas, and draw on the aspects of language which Anees was familiar with, or more comfortable with, to help make those unfamiliar areas more accessible for him. In other words, assessment helps a teacher asses his own process of teaching, and decide which areas need to be focused on and which areas can now be left on the student to practice in his own time.... Only after I understood what the student was seeing could I understand what would benefit the student, and therefore provide the necessary means of delivering that lesson. It basically allowed me to assess him based on what was challenging to him as a learner who was struggling to understand the language, rather than as the student of someone who was very fluent in the language. Another misconception I quickly became aware of was that I had always thought assessment was purely for the benefit of the student. While this is partially true, in an indirect way, assessment of a student can also greatly benefit the teacher. In fact, for a good teacher the assessment of a student is vital because through assessing the student, one is able to assess himself as a teacher, possibly better than he could through any other method. When a student struggles with certain aspects of language, but cannot point out exactly where, assessment helps to narrow it down and give information of which areas ne ed more practice and which areas the student is weak in. This allowed me, as a teacher, to focus on those areas, and draw on the aspects of language which Anees was familiar with, or more comfortable with, to help make those unfamiliar areas more accessible for him. In other words, assessment helps a teacher asses his own process of teaching, and decide which areas need to be focused on and which areas can now be left on the student to practice in his own time. Through the various assessment tasks I provided Anees, I found very clear insight into which aspects troubled him, which in turn made my job of teaching him much easier. Therefore, it can be said that assessment of a student is also a means of assessment for the teacher, and both student and teacher can find much to learn

Philosophy as Metaphysics Essay Example for Free

Philosophy as Metaphysics Essay ABSTRACT: Philosophy works with special types of objects: the totalities. The basic characteristics of this type of object are their metaphysical, transcendental, and total character. The character of these objects determines the specificity of language and the methods of philosophy. The language of philosophy represents symbolic language; speculation is the basic method of philosophy. On the one hand, objects of this type emphasis homo sapien as essences capable of constructing such objects, which in turn assumes the ability of human consciousness to make synthetic acts. On the basis of philosophy as metaphysics, an original approach is offered which divides the history of philosophy into periods as well as providing analysis of different philosophical systems. Feature of philosophical activity, as against a science, is the work with special, not physical objects — the totalities, which are constituted by the philosopher. One of such objects is the world, and, in this sense, we often say, that philosophy is a wel-tanschauung (world-outlook) . Certainly, the world as some set of things can be studied by physics (sciences in a broad sense), but in this case a researcher can miss the point that the world is a totality, not just a simple set of things. As distinct from scientific study the philosophy takes its objects as the totalities, which the subject of knowledge cannot study as ordinary objects, because the including the learning subject character of these the totalities excludes any standard scientific approach to knowledge in principle. Others examples of the above mentioned objects (the totalities) are Ego and God. Objects of this type (with some reservations) are a lot of human being phenomena, such as love, virtue, conscience, courage, bravery, understanding and so on. All these objects are those, that the precise fixing of objective criteria of their existence is impossible, it is impossible to create the high-grade theory of these phenomena (for example, theory of love or bravery), as they assume not only objective Contemplator (as it occurs in case of objects of scientific knowledge), but also postulate the Actor inside them, that causes essentially twinkling way of them being. (2) Exactly the character of these objects determined essential features of the philosophizing as metaphysical activity. The underlining of metaphysical character of philosophy objects dictates the special procedures of work with them, distinct from of methods of scientific knowledge. Metaphysical objects — constructs cannot be given in frameworks of physical experience; the study — constructing of these objects occurs by a way of thinking means, procedures of speculation. That is why the one of the most typical mistakes in the researching of these objects is procedures of naturalization metaphysical objects, i. e. consideration of natural (physical) analogs of these objects. For example, instead of work with the world (the world as totality) we consider the world as some sets of physical, chemical, biological etc. objects, and instead of the analysis of phenomenon of consciousness proper as metaphysical object the natural analog of consciousness — brain or mentality of the particular human being, we examine. Specifying the status of these objects, it is possible to tell, that the subject of the philosophy activity are metaphysical-transcendental objects, i. e. objects having the boundary status of their existence. The boundary character of these objects allows to specify Kantian distinction sensible phenomena and transcendent things in itself. Moreover, metaphysical-transcendental objects are located on border of other known distinctions of classical philosophy. (3) They are, for example, not subjective and not objective, not conscious and not material. It is interesting in this respect appearance of the first proper philosophical category of being, which, in fact, was entered Parmenid`s as boundary metaphysical-transcendental object being-thinking (in this case, alongside with Parmenid`s postulating his first thesis, entering a category of being, presence of the second his thesis, establishing the coincidence of an entered category of being with another category — the category of thinking). In some sense, metaphysical-transcendental objects are Husserl`s phenomenal, from which as a result of procedures of objectivizing and (or) subjectivizing the subjects and objects can be received, i. e. is entered subjective-objective distinction of New time. On the other hand, the boundary character of these objects allows still to work with them ( I specially avoid the term to learn, as far as these procedures are applied only for work with usual objects). Above this mode of working with them was named as speculation, which, as a result, the construction of these objects to occur by a way of thinking means. The creation such thinking construct is caused by that the person aspires to understand mode of functioning of the totalities, which surround him. And just this phenomenon of surprise before presence of such totalities is a beginning and basic nerve of philosophy. In this sense, philosophizing is possible only as an act of work of the beings, capable to postulate these totalities, due to synthetic acts (Kant), as being, perceiving the environmental world not in itself, but by means of symbolical function (Cassirer), through a prism of the transformed forms (Marx, Mamardaschvili). Another important characteristic of metaphysical objects is their total-making nature. It means, that the purpose of designing such objects is the attempt of understanding of some phenomenon of totality (for example, the world as whole, totality) in light of a question how (why) this phenomenon is possible?. The answer to this question assumes revealing mechanism of existence of this phenomenon. That is why it is important for the philosopher not to know some common aspect, that is allowed at a level of the primary, superficial description of it and other similar objects, but to know general (total) principle of functioning of objects of this type. For example, if a row of the plane polygons is given to us, a triangle(4) will act as general principle of this variety, because all others plane polygons can be given with the help of a triangle. Thus, philosophical constructs act as transcendental condition of seeing of other physical objects. That the phenomenon of seeing of a house was possible as some totality, it is necessary to postulate a row of transcendental conditions of this phenomenon, among them we can allocate necessity being of the house (Parmenid), recognition (and taking shape) this being by means of idea of home (Plato), fixing the house as an object of perception by some subject (Decartes) within spatial-temporary a priory forms of sensuality (Kant). On the other hand, a row of such philosophical constructs define a horizon, a way of seeing of subjects (Wittgenstein), associated with a certain epoch. For example, the mentioned above transcendental conditions of a phenomenon of seeing of a house define a way of seeing of subjects within the framework of classical philosophy. In this sense these constructs act as total-necessary cultural machines, that set the cultural way of living activity of the person and made imperceptible but essential background of his existence. For example, when a modern man looks at star sky, he sees not simply separate stars, but constellations — and it is impossible to explain to a person from other culture (and the more so, being, which is not having ability to the synthetic acts). Moreover, developing this example with constructing of constellations, it is possible to tell, that exactly it has made possible occurrence of such activity as an astrology. The above mentioned metaphysical character of philosophy objects causes the specification of the language and methods philosophizing. The language of philosophy has not signal, but symbolical character. Lets stop on it hardly more in detail. Already science differs from the common sense description, because it uses some abstraction, ideal elements, which, in a common case, it is impossible to compare any certain objects of the physical validity. For example, as D. Gilbert says, in mathematics, those are language fictions, and one of the main problems of a substantiation of mathematics is either an exception these fictions, or imposing some certain restrictions — all that prevent the appearance of negative consequences, while using language fictions. Any language works with signs, besides that, any theory deals with mentioned language fictions (=  «symbols »), i. e. such kinds of signs, with which nothing corresponds in sensible reality. For example, in physics has concepts a material point, an absolutely black body, etc. They are often called as abstract — ideal objects, which turn out by a way of abstraction (idealization) from any properties of real physical objects. But in physics there are and more fictitious objects: cwarcks, for example, which not only is evident not imagine, but also until last time have acted only as theoretical constructs essentially of unobservable nature. In this case we can postulate a metaphysical mode of existence for these objects. It is important to emphasize, that these metaphysical objects do not exist in the same sense, as it is for the particular objects of a physical reality, such as table, chair,etc. The majority of the philosophy terms, its categorical apparatus have such symbolical character. It is impossible to give any referents of philosophical categories inside a physical reality. We can take as an example of such philosophical categories as being, consciousness etc. , for which we can somehow find certain physical analogues (for example, for a philosophical category  «being  » such analogue is the category  «substance » or matter). But there are more humanitarian objects connected with some features of a human being way, for which in general there are no analogues in a nature. These are, for example, concepts virtue, conscience, love, debt, bravery This specification of the philosophy language, which symbols indicate an existence of a special metaphysical dimension of a reality could be expressed by Kantian exclamation Excuse me, but it is not, what I speak about (mean)! in reply to German poet Schiller`s misunderstanding his categorical imperative. The metaphysical character of the categorical philosophical apparatus predetermines also specification of philosophical reasoning. The postulated non-sense character of perception of objects of the filosophizing assumes the special procedures of work, which were above characterized as a procedure of speculation. The main difficulty thus — is absence of a support on sensible analogy, which often helps us in daily life. The structure a reasoning about pure being (or conscience) is principle different from the reasoning about a tree, or a sex, or other objects of the physical world. Danger, which here waits us — influence of our vital experience, influence sensible hooks, which can destroy the ability for the reflex and philosophical analysis. To explain the idea about involuntary influence ours sensible apparatus, M. Mamardaschvili in the lectures about M. Proust, used as an example biblical commandment when they beat you on the one cheek — put another one as a vivid example of inhibition (Husserl`s  «phenomenological reduction ») of a standard human reaction (reflex), imposed to us by sense-figurative thinking (if somebody hearts you — reply with the same). Moreover, it is possible, that some other logic operates in area of speculative objects, distinct from usual, earthly logic. In particular, according to opinion of the Russian philosopher and the logic N. A. Vasiljev, validity of the logic law of excluded third, has purely earthly an origin and it is connected with primacy, after Aristotle, of individual existing things. (5) If we, following Plato, consider classes of subjects as primary (for instance, subject a class of tables), the law of excluded third will be incorrect, as the table as one of set of subjects of a class of tables can be simultaneously both white and non-white (in instance, green). Of course, here it is necessary to realize, that the opposite properties are attributed to the different individuals of primary subject — different things of the same class). The transfer of the point of view from single objects to classes of objects has allowed N.Vasiljev to formulate imagined logic with the law of excluded fourth. This logic in anything does not concede on its parameters to our habitual logic with the law of excluded third, but expands opportunities of our thinking. Within the framework of this logic the paradoxical coincidence between maximum and minimum, revealed Nikolaj from Kuza, does not cause surprise. The only acceptable procedure for understanding of philosophical categories within of some philosophical framework is the correlation of the different speculative (metaphysics) objects with the help of a method language game.

Discussion of Management of Patient Traction

Discussion of Management of Patient Traction 1. List nursing interventions and preventative management related to skeletal traction. a. The weights used by the patient should be known and recorded in the nursing documentation; the weights must not be removed from the skeletal traction unless a life-threatening situation happens for removal of these destroys their purpose. b. The traction system must be thoroughly checked at least once every shift or every 6 to 8 hours and always after some interventions such as moving a patient, physiotherapy, and radiographic examination because the system may be inadvertently altered. c. The nurse must guarantee that the cords are attached securely by standard knots that will not shift or come undone, the weights hang freely and should not rest on the floor nor catch or jam, the ropes are in the wheel grooves of the pulleys, and that the ropes are not frayed. d. The ends of the cords must be short or approximately 5cm and bound back to themselves with the use on an adhesive tape which will prevent fraying of the cord end and possible slipping and accidental disruption of the traction. The knot itself should also be uncovered. e. The pulleys must be free running and oiled to prevent squeaking and friction should be minimized, the efficiency is maintained and the patient should not be disturbed by noise. f. Pointed ends of the pins or wires used should always be covered to prevent injury not only to the patient but also to the staff. g. The nurse should also evaluate the patients position; the patient should be on a firm-based bed to give full support and comfort to allow efficient action of the traction system and prevent the patient from slipping down the bed. h. the nurse should maintain alignment of the patients body in traction as ordered by the physician which will promote an effective line of pull. i. The patients foot is positioned properly to prevent foot drop, inward rotation, and outward rotation otherwise the foot can be supported by orthopedic devices such as foot support to maintain a neutral position. j. The elbows and knees should be protected with the use of a semi permeable film dressing or protective wool and inspected for pressure ulcers because these parts of the body are often used by patients in repositioning themselves. Also, to prevent these parts from being injured, an overhead trapeze can be helpful for the patients movement. k. Back care should always be provided and bed should be kept dry and free from crumbles and wrinkles to prevent bed sores or pressure ulcers. l. If available, a pressure relieving air-filled or high density foam mattress overlay can be used to reduce risk for pressure ulcers. m. The bed linens should regularly be changed. The patient is instructed to raise his torso while the nurses on both sides of the bed will roll down and replace the upper mattress sheet and as the patient raises the buttocks off the mattress, the nurses will slide it under the buttocks. To finish the changing, the nurses will replace the lower part of the bed linens while the patient rests on his back. The traction should not be disrupted. n. The neurovascular status should be assessed initially every hour and then every 4 hours. o. The nurse should instruct the patient to report instantly if any change in sensation or movement happens. p. The patient should also be encouraged to do active flexion-extension ankle exercises and calf-pumping exercises ten times hourly to prevent venous stasis or DVT. Anti-embolism stocking and compression devices may be used for preventive measures. q. The nurse should also inspect for looseness of pins or wires and signs of infection at the sites where the traction is inserted every 8 hours. Purulent discharge, redness or inflammation may indicate infection, though these signs subside normally after 72 hours. r. Pins that are mechanically stable require weekly pin site care. The most recommended cleansing solution used is chlorhexidine solution. If early signs of infection are present, frequency of pin site care is increased. s. The nurse ensures that the site is only covered by a sterile absorbent non-stick dressing and rolled gauze for the first 48 hours. After this, loose cover dressing or none is suggested. A bandage will only be used if the patient is exposed to airborne dust. t. The nurse should instruct the patient to take showers within 5 to 10 days of pin insertion and encourage them to leave the pin exposed to water flow and dry them with a clean towel and left to open air. Dressing may be applied if ordered. u. The patient is encouraged to perform active exercises to prevent loss of muscle mass and strength and prolonged rehabilitation. The patient can perform the following: pulling up on the trapeze, flexing and extending the feet, ROM and weight-resistance exercises for the non-involved joints. v. Isometric exercises of the immobilized extremity such as gluteal-setting and quadriceps-setting exercises are important for maintaining strength in major ambulatory muscles. 2. Discuss a component of cast care for the pediatric client or adult client. Identify manifestations of compartment syndrome. After cast application, the nurse must teach the client to report the following: a. When the toes or fingers become blue, swollen or difficult and painful to move b. When the limbs become painful c. When the client feel numbness d. When the client have blister-like or burning pain e. Presence of discharges or wetness or unpleasant smell from the cast f. If the client dropped anything from the cast The nurse must also teach the client or the care taker the following proper care of the cast: a. The cast should be kept dry. Allowing it to dry naturally is a must and it should be left uncovered. b. External heat such as a hairdryer or by sitting in front of a fire should be prevented. c. If an irritation occurs under the cast, anything under the cast should never be poked. d. The skin around the cast should be washed daily and checked for redness or sores. e. The limb must not be hanged down especially on the first few days. f. Exercises for the fingers or toes and other joints of the body should be performed for 5 minutes every hour during the day. There are certain nursing interventions and care after cast application. The following will be discussed below. a. Self-care deficit The goal of care is for the client to maintain everyday activities to a level acceptable for him. The client may need help to achieve this level. The nurse must assess the clients capabilities which will depend to a number of factors such as the site of the cast, the previous level of independence, the support available from family or friends, and some may require referral to a social worker. b. Peripheral neurovascular impairment The goal of care is to reduce the risk of neurovascular impairment and identify any early complications. The nurse must do neurovascular observations and if neurovascular impairment such as compartment syndrome is suspected, the following interventions should be done: Inform the physician immediately Cease elevation of the limb because elevation can increase compartment pressure The cast should be split down to the skin. Threads of padding should not be left uncut for it can impair the circulation If local pressure on the nerve is present, a window is needed to be cut or the cast is bivalve Compartment syndrome requires immediate surgery. (I will duscuss it after these nursing diagnosis and care) c. Impaired skin integrity The goal of care is to indentify signs of localized pressure because cast may cause pressure or localized sores. These are the following signs that should be observed by the nurse: Itching beneath the plaster Burning pain; which should not be ignore because the tissues quickly becomes ischemic which leads to numbness and absence of pain Disturbed sleep, restlessness and fretfulness in children Swelling of the fingers or toes after the immediate swelling has subsided A characteristic offensive smell due to tissue necrosis Presence of discharge The nurse must know that extra padding to a cast can increase the pressure and the padding can fall further down the cast. Cotton wool should not be used for padding because it tends to be compressed into hard small pellets that can cause further problems when it falls into the cast and become lodged. A window should be cut carefully and removed as a whole piece for inspection of potential sore sites but the window should be replaced to prevent local edema. d. Risk for disuse syndrome (stiffness of the joint) The goal of care is to ensure that the adjacent joints retain their normal range of motion because stiffness will occur in joints held in a cast. Such exercises that was discussed before is vital in relation to the importance of using adjacent joints. e. Potential allergic reaction The goal of care is to prevent reactions in client known to have had a reaction in the past and for early detection of any reaction occurring in other clients. The nurse should check if the patient has known allergies. Signs or reaction should be observed such as itching, non-localized burning pain, rashes and blistering of the skin. If these occur, the physician is informed. The cast is removed, the skin is cleaned and a new cast is applied using a different material. Compartment Syndrome If the patient complaints that the cast is too tight, nerve compression and vascular insufficiency can occur due to unrelieved swelling. This can result to compartment syndrome. The cast may be bivalved to relive the pressure while maintaining alignment with the extremity elevated no higher than the level of heart to ensure arterial perfusion. If it is not relieved, fasciotomy is required to relieve pressure built up in the muscle compartment before irreversible damage occurs to the ischemic muscle. 3. Compare the nursing needs of a total hip replacement patient with a total knee replacement patient. Nursing Needs of a Total Hip Replacement Patient A patient with a total hip replacement requires monitoring for specific potential complications especially the dislocation of hip prosthesis. Nursing needs are more focused on the dislocation of the hip prosthesis. If the patient is undergoing a posterior or posterior-lateral approach for total hip arthroplasty, maintenance of the femoral head component in the acetabular cup is important. The leg should be positioned in abduction to prevent dislocation of the prosthesis. An abduction splint can be used to keep the hip in abduction. Hip should never be flexed more than 90 degrees. Limited flexion is maintained during transfers and when sitting. There are methods to avoid displacement of the hip such as keeping the knees apart at all times, putting a pillow between the legs when sleeping, never crossing the legs when seated, avoding positions such as bending forward when seated in a chair and when picking up an object on the floor. A higg seated chair should be used and a raised toilet seat. The hip should also not be flexed to put on clothing such as pants, stocking, socks, shoes, etc. Monitoring the wound drainage, preventing deep vein thrombosis and infection,are also important for the patient. Nursing Needs of a Total Knee Replacement Patient In other hand, a patient with total knee replacement focuses on the importance in encouraging active flexion of the foot every hour postoperatively, when awake. Also, drainage should range from 200 to 400mlduring the first 24 hours after the surgery and reduces to less than 25ml by 48 hours at which time drainage is removed by the surgeon. A continuous passive range of motion or CPM device combined with physical therapy will help improve the patients postoperative knee mobility and decrease use of analgesics. Usually, 10 degrees of extension and 15 degrees of flexion are prescribed initially, then increasing to 90 degrees of flexion with 0 or full extension by discharge. The knee is usually protected with a knee immobilizer and is elevated when the patient sits in a chair. Ambulation, use of assistive devices and within the prescribed weight bearing limits is encouraged on the day after surgery. 4. Discuss methods to avoid dislocation after hip replacement after surgery. There are several methods to avoid dislocation of the hip prosthesis. These are the following: a. The knees should be kept apart at all times. b. A pillow should be placed between the legs when sleeping. c. Legs should not be crossed when seated. d. Bending forward when sitting in a chair should be avoided. e. Bending forward to pick up an object on the floor should also be avoided. f. A high seated chair and a raised toilet seat should be used because the knees should be lower than the level of the hips when seated. g. The hips should not be flexed to put on clothing such as pants, stockings, socks, or shoes. 5. You are caring for a patient who has had skeletal traction placed to treat a fractured femur. Discuss nursing interventions and assessment techniques related to this type of treatment. When caring for a patient with a skeletal traction on a fractured femur, these arethe nursing interventions and assessment techniques the nurse must do: a. The nurse must check the traction system daily, at least every 6 to 8 hours and always after moving the patient. b. The nurse must also inspect for looseness of pins or wires and signs of infection such as discharge, redness and inflammation at the sites of insertion of the traction. c. Pin sites should be cleaned twice or once daily; chlorhexidine solution is the most recommended solution to use for cleaning. d. Skin breakdown should be prevented by covering the bony prominences used by the patient when moving such as the elbows and heel. e. An overhead trapeze is given to the patient for easy movement. f. The neurovascular status of the fractured femur should be assessed every 4 hours. g. The patient should be encouraged to do calf-pumping exercises for at least 10 times per hour to decrease the risk for deep vein thrombosis of the affected part. h. The use of anti-embolism stockings can also help prevent venous stasis. g. Active exercise such as pulling up on the trapeze, flexing and extending the feet and isometric exercises will maintain strength in major ambulatory muscles. i. Assisting the patient will self-care such as bathing, dressing and toileting is also one of the nurses responsibilities. j. The nurse must also monitor the patient for any potential complications such as DVT, constipation, etc. 6. A patient is being discharged with an external fixator for a fractured humerus. Discuss home care instructions for this patient. Home care instructions for a patient with an external fixator include the following: a. The nurse must demonstrate proper pin site care. The solution that must be used is chlorhexidine solution, and cleaning is once or twice a day. b. The nurse should inform the patient to notify the physician if signs of infection such as redness, tenderness, increased or purulent pin drainage occur. c. The nurse should also describe measures to control swelling and pain such as elevating the extremity to the heart level and taking prescribed analgesics. d. The nurse informs the patient to report uncontrolled pain upon elevation and use of analgesics for it could be an indicator of impaired tissue perfusion, compartment syndrome, or pin traction infection. e. The nurse should also let the patient demonstrate the ability to transfer and use mobility aids safely. 7. Identify various types of traction and the principles of effective traction. a. Skin Traction It is used to control muscle spasms and to immobilize an area before surgery. No more than 2 to 3.5kg of traction can be used on an extremity. b. Skeletal Traction It is applied directly to the bone and is used occasionally to treat fractures of the femur, tibia, and the cervical spine. Two types of pins are commonly used; the Steinmann pin, and the threaded pins such as Denham pin. There are also common types of traction used. These are the following: c. Straight-Leg Traction It is also known as Pughs traction which allows the traction cord to be fixed by trying it to for example, the end of the thomas splint or used as sliding traction using a pulley and weights. It is used as a temporary measure for fractured neck of femur injuries, to rest the hip or relieve pain or muscle spasm. d. Hamilton-Russell Traction It is traditionally been used for fractures of the neck and the shaft of the femur. The arrangement of the foot pulleys multiplies the traction force by 100%. To ensure Effective traction, avoidance of wrinkling and slipping of the traction bandage is important. Also, it is a must to maintain countertraction. Proper positioning is maintained to keep the leg in neutral position. Advice the patient not to turn from side to side. This will prevent bony fragments from moving against one another. 8. Discuss the use of Bucks traction, its uses and the involved nursing considerations. Bucks Extension traction is used to the lower leg. It is a type of skin traction that is used to immobilize fractures of the proximal femur before surgical fixation. During application of the Bucks Extension traction, excessive pressure is avoided over the malleolus and proximal fibula to prevent pressure ulcers and nerve damage. The prescribed weight is usually 5 to 8 pounds. 9. Discuss the nursing care for a patient undergoing orthopaedic surgery. a. Relieving pain is the first goal for the patient. Decreasing the discomfort by moving the affected bone or the injured joint can help. b. Elevation of the edematous extremity will promote venous return and reduce the discomfort. c. Giving alangesics as ordered, d. Monitoring and maintaining the neurovascular status of the patient. e. Assisting the patient in performing activities. f. Assessing the nutritional status and hydration by monitoring fluid intake, urinary output and urinalysis findings. g. Encouraging mobility immediately after surgery to promoted independence in ambulation. h. Assisting the patient in accepting body changes, diminished self-esteem and roles and responsibilities. SOURCES: Brunner and Suddarths textbook of Medical-Surgical Nursing 12th Edition Julia Kneale et. al. (2005) Orthopaedic and Trauma Nursing 2nd Edition Web Assignment 1. Find a research article addressing health teaching needs for the patient with a cast. Explain your findings in a one-page paper. http://www.uptodate.com/contents/patient-information-cast-and-splint-care According to the article, a cast is used to protect your bone and reduce pain as it heals. Minimizing the risk for potential complications is important. It was enumerated in the article some cast care instructions and they are as follows; the cast should be kept above the level of the heart within 24 to 48 hours which can be accomplished by resting it on pillows. Also, fingers and toes where the cast is located should be moved gently. The ice keeps the swelling down. Applying a bag of ice of a bag of frozen vegetables covered with a thin towel to the cast for 20 minutes while awake reduces swelling. The patient should be reminded that ice is not applied directly into the skin. Pain medications should be taken as ordered such as ibuprofen and acetaminophen. The cast should not get wet. To bathe with a cast, cover the cast with a plastic bag and tape the opening shut. Then, the cast is hung outside the tub. Even if the cast is covered with a plastic, it should not be placed with water or allow the water to run over the area. There are waterproof cast available at medical supply stores but are not completely waterproof. A hair dryer on a cool setting can be used to dry the cat in case it got wet, it can also soothe itchiness. Warm or hot setting can burn the skin that is wise it is not advised to be used. A vacuum cleaner can also be used with a hose attachment to pull air through the cast and speed drying. The patient should always remember that the cast should be kept clean. Powder or lotion should not be applied near the cast and the cast should be covered when eating. The padding out from inside the cast must not be pulled. There are also instructions said when to seek care. These are as follows; if there are sore areas or a foul odor from the cast, cracks or breaks in the cast, or the cast feels too tight, if swelling is developed that causes pain and immobility of the fingers or toes, if tingling or numbness is felt on the affected part, if the fingers or toes are blue or cold, if there is severe pain in or near the affected part, and if it becomes soaking wet and does not dry with a hair dryer or vacuum.

Oscar Niemeyer Design Philosophy

Oscar Niemeyer Design Philosophy Being born as the son of Brazils Federal Prime Minister, Oscar Niemeyer was living in a Portuguese colonial style house with beautiful tropical setting: a wide carriageway, neatly lined with tropical trees, that curves along the broad seawall looking out to the dome of Pao de Acuacar guarding the bays mouth; lawn designed as formal gardens Niemeyer obsessed over the landscape of his motherland Brazil. No matter how different his house designs vary through time, the element of landscape is always strong and evident. This essay focused on Niemeyers house designs. Being an icon of modern architecture, Niemeyer pushed the limit of reinforced concrete and revealed the expressive charm of this artificial material. The contemporary architecture was monotony. Niemeyer wanted to challenge it. Niemeyer is well-known mainly because of his design for some of the most dominant governmental buildings in Brasilia, Brazil. As one of the early pioneers of modern architecture, Niemeyer opened up a unique approach to contemporary architecture using bold free-form curves in design. Some of his house projects were equally powerful in terms of his dramatic application of free-form. But other projects indicate more thoughts in Brazils colonial background and his own formal exploration throughout his career. Niemeyer did a series of house projects with a huge time span from 1936 until now. Among the dozens of house projects, there are extremely luxury houses he designed for wealthiest Brazilians, there area also some house he designed for middle-class friends and family. Niemeyer also designed four houses for himself. One house, Casa das Canoas, was his most published and well-known work. Four houses designed in year 1942, 1949, 1953 and 1960 had varies characters and different concepts. As Niemeyers other house design sometimes have to fulfill his clients requirements, his own house designs seems to be trademarks of his career, evolving through different phases. The first house he designed for himself is located on a sloping site in Lagoa, Rio de Janeiro. Graduated from National Fine Arts School in 1934, Niemeyer was deeply influenced by Le Corbusiers visit to Brazil in 1929. He joined Costas office in 1935, and from 1936-1942, he was working mainly on the Ministry of Education and health Building, on which, Le Corbusier was invited as project consultant. During this period, influence from the modern master was obvious and they got clearly reflected in Niemeyers first house. The three story house was zoned with clear rationality. The main living room and bedrooms are clearly separated from the service area. A set of scissors ramp is just identical as the one appeared in Le Corbusiers Villa Savoye in terms of its function as the only connection between different floors. The rectilinear upper floors sit on columns on the ground floor, with curvilinear walls direct the flow from entrance to garage and later towards the ramp. Horizontal openings on the facade give a clear indication of free elevation. However, the house is not a simple duplication of Le Corbusiers work. Niemeyer started to explore forms and material in the context of Rio, which is a humid tropical Brazilian city. A single direction slanted rooftop deals with the massive rain water during the monsoon season. A veranda on the second floor fully opens to the lake view. The material he used for the elevation is also unique. Different from his later larger public buildings which mainly deals with reinforced concrete, brick and wood was applied as elevation infill. On the top floor, the wall is composed with wood trims originally painted in blue. Wooden louvered panels were added to cover the veranda. Wood was also widely used as the material for interior finishes as well. The symbol of house as a machine, ramp, in Villa Savoye was no longer represented in cold metal frames and concrete finish. It was covered in wooden panels on the side and a wooden frame. On the ground floor, bushes were planted from the irregular sit e boundary towards the hose edge, defined by a hard pavement following the outline of the elevated second floor. In this project, although marks from Le Corbusier are clear through the use of free plan and clear zoning in a house project. Niemeyers awareness of context and site was already obvious. This prototype of dwelling on top of the landscape evolved and became one of the most frequently used prototypes in his later house designs. In 1949, Niemeyer designed another house in Mendes, RJ. The house was built and later demolished. The house has a very dominant feature which was the slanting screens shelter the porches for living room and bedrooms. Different from his first house for himself, this house was located on a flat piece of land with the trees surrounding it and a stream runs in front of it. The setting is purely natural, not urban. The difference in the context led to a very different design solution. The single floor house is organized in a rectilinear order with all the rooms facing the screen and indoor garden in between. Here, a hint can be found between his modernist approach and traditional colonial architecture. The old colonial porch was transformed into a screened indoor garden, blending the artificial indoor and purer nature outside. This became a prototype which the landscape and the artificial indoor environment was articulated on the same level through a buffer garden. In 1953, Niemeyer designed his most published house, Casa das Canoas. The design was open to the world and shocked the audience with its curvilinear roof. Just before the CIAM meet for the first time in Brazil in 1954, the house was finished. Niemeyer faced some of the most dominant figure in modern architecture with their critics on the house. Walter Gropius and Mies van de Rohe were both attracted to its beauty but pointed out the uniqueness of its geometry became he limit that it can not be multipliable. Faithful to his ideology of mixed ancestry and Antropofagist hybridization, Niemeyer proceeded to infect the classical pavilion with the organic, spontaneous architecture of the morros, mixing Western achievements in the field of domestic architecture with tropical exuberance and lessons from Brazils colonial past and popular present. Case das Canoas is one example of Niemeyers treatment of continuity between the interior and exterior. Curve and landscape became the media that he utilized to achieve it. With the irregular curvilinear roof lines, the nature surrounding the house became closer and farther, varies according to the geometry. A large piece of rock placed right at the edge of the glass wall, penetrating the transparent faà §ade and made it even less dominant. The warm wood finish of the interior partition wall conter-balance the rigidity brought by the steel frame of the glass faà §ade. The white ceiling and black floor becomes the frame of the this transition between na ture and artificial. The exploration of the form continued and became more vigorous when he designed an unbuilt house in Tel Aviv, Edmond de Rothschild House. This time with the desert becomes the setting, the free-form geometry was reverted from edge of the house to its inside. A free-form garden is enclosed by a rectilinear volume. Just at the time when Niemeyers free-form house design became a signature image. In 1960, he designed his house in Brasilia in a totally traditional colonial style. It creates a very strong contrast between the ideology of Brazils independence and its colonial historic roots. On the one hand, with the huge governmental projects, Niemeyer was creating the most powerful formal language, trying to declare to the world that Brasilia represents Brazils new future. On the other hand, he showed his respect very thoroughly to the colonial style, honest and modest. The houses feature a covered porch with red-tiled gable roof, whitewhased walls and regularly spaced windows. More houses will be discussed following the category of the four houses Niemeyer designed for himself. These houses includes: Edmundo Cavanelas House Allvorada Palace Carmen Baldo House Burton Tremaine House Weekend house for Juscelino Kubitschek Cavalcanti house Overlaid with the complexities of Brazils history and stratified society, these scenes evoke contradictions that Niemeyers designs have always balanced: natural shapes created by artificial technology, structural logic and ecstatic emotions, simple forms and complex purposes. Niemeyers house design showed his critical thinking and evolving career, just as strong as his public buildings. His public building may be restricted to their formal strength as a responsibility to speak for the nation. However, in his house design, there are clear trademarks of his weighing of traditional vernacular concept and modern formal exploration. Curves in Niemeyers house projects are more utilized as a mean to explore the relationship between nature and artificial, building and landscape, indoor and outdoor etc.