Sunday, January 26, 2020

Inhaled Salbutamol: Effects on the Body

Inhaled Salbutamol: Effects on the Body Introduction Salbutamol is a first-choice bronchodilator drug used in the acute treatment of asthma. Asthma is a chronic respiratory disease which causes recurrent reversible airway obstruction. An asthma attack is often triggered by an immediate hypersensitivity reaction that occurs in response to an inhaled allergen, causing acute bronchospasm in the lungs. Salbutamol treats the symptoms of asthma by reversing this bronchoconstriction. It acts as a ÃŽ ²-2-adrenoreceptor agonist, and when inhaled, it binds to beta-2-adrenoreceptors in the bronchial smooth muscle of the lungs, causing the muscle to relax. This leads to dilation of the bronchioles and improved airflow. Salbutamol has been shown to cause side effects such as tachycardia, muscle tremor, an increase in systolic blood pressure and a decrease in diastolic blood pressure. When salbutamol is absorbed into the bloodstream via the lungs, it can bind to ÃŽ ²-2-adrenoreceptors present on the heart and increase the heart rate. The stimulation of beta receptors also stimulates an increase in myocardial contractility which can increase pulse pressure. Salbutamol is usually administered by inhalation of aerosol, powder or nebulised solution, although it can also be administered intravenously. A metered-dose inhaler (MDI) is normally used for aerosol administration, which provides a standard dose of salbutamol. The spray from a MDI consists of rapidly moving propellant droplets, most of which impact in the mouth and throat where salbutamol absorption is poor, and only about 10% of the inhaled drug reaches the bronchioles. 2 This proportion may be further reduced by poor inhaler coordination since many patients fail ,3 to synchronise the firing of the aerosol with inhalation. With good coordination about 15% of the dose would be expected to reach the lungs.3 Using a spacer device has proved to raise deposition of salbutamol in the lungs to levels similar to or greater than those obtained from a correctly used metered dose inhaler. (Thorax 1984;39;935-941) The spacer is a large plastic container with a mouthpiece on one end and opening at other end where MDI is attached, and is most often used by young children and the elderly. The aim of this study was to determine the acute effects of inhaled salbutamol on heart rate, pulse pressure, and peak expiratory flow rate and to compare the efficacy of salbutamol delivered by metered-dose inhaler (MDI) with that of salbutamol delivered by metered-dose inhaler attached to a spacer (MDI-spacer). The efficacy of the two methods of salbutamol delivery were analysed by comparing the bronchodilator and cardiovascular effects of salbutamol in subjects taking the MDI and MDI-spacer. Materials and Methods 18 healthy subjects were studied with an age range of 18-35 (14 females and 4 males). Salbutamol (Ventolin ®) was supplied in pressurised, metered dose inhalers (MDI). The 18 subjects were divided randomly into three groups: placebo, MDI and MDI-spacer. Subjects in the placebo group used the placebo MDI inhaler which acted as the control. Subjects in the MDI group used the salbutamol MDI. To administer a standard dose of salbutamol, they exhaled fully, and then inhaled slowly through the opening just as the drug was released from the MDI, and then held their breath for 10 seconds. [manual]. Subjects in the MDI-spacer group used a salbutamol MDI with an attached spacer device. To inhale a single dose of salbutamol, the subjects attached the MDI to the end of the spacer, breathed in deeply through the mouthpiece and then held their breath for 10 seconds [Introduction to Exp Bio] .The standard dose released with each depression of the salbutamol MDI was 0.1mg. For each subject, control readings of heart rate, pulse pressure and peak expiratory flow rate (PEFR) were taken at 3 minute intervals for 12 minutes. At 12 minutes, two successive doses of the assigned inhaler were taken (2 x 0.1mg doses= 0.2mg), immediately after which the three variables were measured. This was repeated every 3 minutes until a total dose of 0.6mg salbutamol or placebo had been administered. Heart rate was measured manually using a stethoscope and stopwatch. Diastolic blood pressure (DBP) and systolic blood pressure (SBP) were measured by using a sphyngomanometer and a stethoscope. [manual]. The pulse pressure was then calculated by subtracting the SBP from the DSB. The PEFR was measured using a Wright peak flow meter. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS), version 16.0. The data were assumed not to have a normal distribution, and the results obtained from the different groups were independent of each other. The non-paired, non-parametric Mann-Whitney-U test was therefore used to determine whether there were significant differences in any of the measured variables as a result of the salbutamol MDI, when compared to the placebo control. The test was also used to determine if there was a significant difference between the results of the MDI and MDI-spacer groups which would have been caused by the use of the spacer. For each subject, the overall change in a variable from the mean control value after a 0.6mg dose, was used to compare the results of subjects from different groups. Mann-Whitney-u test to compare results recorded for each group to see if the differences observed are significant at the 95% confidence level. A value of P

Saturday, January 18, 2020

Phidias & Associates Essay

In the best interest of the productivity and success of Phidias & Associates, I’d like to suggest the adoption of a corporate strategy already in use by NASA and other leading countries across the world. Corporate napping is an exceptionally cost-effective and efficient way to improve the accuracy, alertness, and speed of workers by as much as 34%. The conversion of Phidias & Associates to a nap friendly zone would enhance the experience of around 92% of employees. Immediate improvements in energy, creativity, problem-solving, and job satisfaction would be in the bright future of this company. The first step to realizing the reality of this advancement is the addition of a nap room to the offices of Phidias & Associates. What other room in our building can offer such impressive gains for our country? A nap room doesn’t need to be elaborate. Many companies utilize a sound proof room, several couches, and a dimmer switch to provide a place for employees to recharge and renew. Rather than rearranging the office space, I’ve discovered an even easier alternative for the company to immediately begin reaping the benefits of corporate napping. The company MetroNaps rents and sells individualized EnergyPods to high-paced future-thinking organizations like Phidias & Associates. For only $12,485, we could purchase an EnergyPod. There’s also the option to rent EnergyPods for only $10/per employee/per month. A productivity boom is only a small investment away! In addition to a place to nap, our employees will require one other change to fully embrace this advancement. In America, a strong negative stigma surrounds the concept of napping in the workforce. This judgment is holding back our country’s and company’s potential for success. Other countries, like Japan, and some of our own country’s top leaders, like Thomas Edison and John Kennedy, utilized napping for its purpose-the restore energy. A few brief informative meetings and distribution of educational materials could change the mindset of Phidias & Associates to view napping as a tool for our company’s growth. Ten and twenty years ago, large and successful companies modernized their facilities by adding fitness centers. Realizing that physical and mental health extends beyond the benefits of exercise, corporate napping is what’s missing from our organization. By becoming a leader in the industry, we can harness the secret gains of this largely unknown trick to boosting productivity. Nap rooms benefit the executives, the employees, and the advancement of Phidias & Associates. Please consider the lofty paybacks of installing a nap room and e-mail me your reply.

Friday, January 10, 2020

Philippine History

Before the so-called invaders of Philippines came here, we proudly say that we are civilized then and stood up by ourselves even without the help of others. Fossils, bones and jars were found from the different parts of the country as a sign of life many years ago. The oldest of which was retrieved in a cave named Kuweba ng Tabon, Palawan. It was said that they lived 22,000 years ago. It stated in the history of the Philippines that the first group of men who came here was the Negritos. They are those who have dark complexion, small, and has curly hair.Their other names were Aetas, Itas, Baluga and many more. It was believed that they lived in caves and in the mountains. After the Negritos were the Indones. They are those who have a white complexion, tall, and tough bodies. To compare the two, the Indones are smart looking people. The last group was the Malays. They were the one having the right complexion, height and characteristics. They were the one who mostly dominated the archip elago. Being civilized persons, they were able to live according to their skills and unbelievable ability to maintain their spirit to live.These people lived peacefully. The neighbor countries such as the China started to trade with the people here. They traded textiles, jars, animals and other tradable materials. It was not easy for the Spaniards to conquer and build a government in the Philippines because the native Filipinos fought for their rights, freedom, and dignity. The first Europeans to arrive were the Spanish led by Ferndinand Magellan {Fernao de Magalhaes (Portugese) Fernando de Magallanes (Spanish)}. He claimed the islands for Spain on March 16, 1521.When he came to Limasawa on March 18, 1521, he united with Raha Kulambu and Raha Siagu of Butuun who are brothers. There, the first mass was celebrated and stationed a cross on top of the mountain. He baptized the place as Kapuluan ni San Larazo. But his vanquishing ended when he tried to conquer Mactan where a brave leader fought him to death named Lapu-Lapu. Miguel Lopez de Legazpi made the first permanent Spanish settlement on Cebu in 1565. In 1571, the islands were renamed in honor of King Philip II. He named the island as Felipinas and the capital was moved to Manila.The name was later changed into Philippines. A governor-general responsible to the viceroy of Mexico headed the colonial administration, but the parish priest was often the only visible symbol of Spanish authority in rural areas, and religious orders controlled education and many great estates. The Spanish came into conflict with the expanding Muslim population and eventually pushed them back to the southern islands, although neither Spain nor the United States at a later date was ever able to subjugate the Muslims completely.The Spanish occupation was inseparably linked with the missionary work of the Roman Catholic church. Trade in Chinese luxury items, gathered in Manila and sold in Acapulco in exchange for silver, was the economi c foundation of the colony until the 19th century, when the independence of Spain's New World colonies forced a shift to the cash-crop economy that persists to this day. In the 1880s a nationalistic movement developed, strongly influenced by the writings of Jose Rizal (1861-96). He spurred Filipino demands for reform.Rizal's execution made him a martyr and the country's national hero and sparked an unsuccessful revolution led by Emilio AGUINALDO. On June 12, 1898, after the outbreak of the Spanish-American War, Aguinaldo declared the Philippines independent in the mistaken belief that the United States supported his struggle. Instead, Spain ceded the Philippines to the United States. In 1899 until his capture in 1901 Aguinaldo led a war against his country's new colonial rulers.Although U. S. business interests applauded the seizure of the Philippines, the U. S.  government declared that it would prepare the islands for independence. In 1935 the Philippines became a self-governing commonwealth under President Manuel Luis Quezon, but World War II delayed full independence. Japan attacked the Philippines on Dec. 8, 1941, defeating U. S. and Filipino forces at Bataan and Corregidor in 1942. The struggle against Japan, culminating in Gen. Douglas MacArthur's return in 1944, came to symbolize U. S. -Philippine solidarity. On July 4, 1946, the Philippines gained full independence with Manuel Roxas y Acuà ±a as president.After World War II, the economic and social infrastructure of the Philippines was a shambles. Inadequate land distribution and unequal taxation fed the Hukbalahap (Huk) guerilla revolt against the government, which was defused in the early 1950s by a resettlement and amnesty program devised during the presidency of Elpidio Quirino by Ramon Magsaysay, who became president in 1953. Ferdinand Marcos became the first president to win (1969) a second term after defeating President Diosdado Macapagal in 1965. In 1972, facing a Muslim revolt in the south , a leftist rural insurgency, and student unrest, Marcos declared martial law.He restored law and order, promoted social and economic reforms (often at the expense of his political foes), and created a political machine that remained dominant after martial law was lifted in 1981. Critics charged that he also enriched himself and his friends at the expense of the country. On Aug. 21, 1983, Marcos' chief political rival Benigno S. Aquino, Jr. , was assassinated as he returned to the Philippines from exile. Marcos loyalists were accused of complicity in the killing, which touched off waves of popular protest.The opposition gained in the 1984 legislative elections and a left-wing insurgency grew steadily, fueled by government repression and a declining economy. To renew his mandate, Marcos called early presidential elections, which were held on Feb. 7, 1986. Opposition leader Corazon Aquino and her running mate Salvador Laurel were backed by much of the business community and the influe ntial Roman Catholic Church. When the National Assembly declared Marcos the victor amid widespread charges of electoral fraud, Aquino launched a campaign of nonviolent resistance to secure the post many believed she had won.On February 22, when defense minister Juan Ponce Enrile and army deputy chief of staff Lt. -Gen. Fidel Ramos resigned, huge crowds of ordinary Filipinos turned out to protect the dissident military leaders, and the United States increased its pressure on Marcos to step down. On February 25, after Marcos and Aquino held rival inaugurations, Marcos left for exile in the United States, which quickly recognized Aquino as president. Aquino took steps to restructure the government and the military, restore civil liberties, promote free enterprise, and retrieve public monies illegally appropriated by Marcos and his cronies.She freed political prisoners, announced her desire to negotiate with leftist leaders, and agreed to honor the treaty allowing the United States to o perate military facilities at Clark Air Base and Subic Bay Naval Base. Despite popular support, however, Aquino faced formidable problems. These included the Communist insurgency, the weak economy, widespread social injustice, continued opposition from Marcos backers, and squabbles within her own diverse coalition. Unable to reach a negotiated settlement with Communist insurgents, she was also criticized for failing to halt corruption.Marcos died in 1989, but many former allies, including former defense minister Juan Ponce Enrile challenged her and Vice President Salvador Laurel, who resigned as foreign minister in 1987 and was named head of the opposition Nacionalista party in 1989. In December 1989, after the most serious of several coup attempts by dissident soldiers was quelled with U. S. military aid, a six-month limited state of emergency was declared. Aquino survived a seventh coup attempt in October 1990.In 1991 the eruption of Mount Pinatubo forced the United States to aban don Clark Air Base, and the Philippine Senate rejected a new 10-year lease for the country's remaining U. S. military facility, Subic Naval Base, weakening the historic ties between the two countries. Defense minister Fidel Ramos, a long-time Aquino supporter who helped her survive seven coup attempts by dissident soldiers, won a seven-way presidential contest in May 1992 with only 23. 5% of the vote. He assumed the presidency on June 30.The last of the U. S.  military and naval units were withdrawn from the Philippines in November, ending a presence that had existed since 1898. Mount Mayon, a volcano situated 330 km (205 mi) south of Manila, erupted in February 1993. He fought for the Philippines 2000 Tiger Economy. His term brought about a progress to the Philippines. The Asia Pacific Economic Congress (APEC) was held in the Philippines during his term. Replacing him was the present President Joseph Ejercito Estrada. Winning the May 11, 1998 election, many controversies arises a nd Filipinos looking forward to a better future having him as the new president. Philippine History Before the so-called invaders of Philippines came here, we proudly say that we are civilized then and stood up by ourselves even without the help of others. Fossils, bones and jars were found from the different parts of the country as a sign of life many years ago. The oldest of which was retrieved in a cave named Kuweba ng Tabon, Palawan. It was said that they lived 22,000 years ago. It stated in the history of the Philippines that the first group of men who came here was the Negritos. They are those who have dark complexion, small, and has curly hair.Their other names were Aetas, Itas, Baluga and many more. It was believed that they lived in caves and in the mountains. After the Negritos were the Indones. They are those who have a white complexion, tall, and tough bodies. To compare the two, the Indones are smart looking people. The last group was the Malays. They were the one having the right complexion, height and characteristics. They were the one who mostly dominated the archip elago. Being civilized persons, they were able to live according to their skills and unbelievable ability to maintain their spirit to live.These people lived peacefully. The neighbor countries such as the China started to trade with the people here. They traded textiles, jars, animals and other tradable materials. It was not easy for the Spaniards to conquer and build a government in the Philippines because the native Filipinos fought for their rights, freedom, and dignity. The first Europeans to arrive were the Spanish led by Ferndinand Magellan {Fernao de Magalhaes (Portugese) Fernando de Magallanes (Spanish)}. He claimed the islands for Spain on March 16, 1521.When he came to Limasawa on March 18, 1521, he united with Raha Kulambu and Raha Siagu of Butuun who are brothers. There, the first mass was celebrated and stationed a cross on top of the mountain. He baptized the place as Kapuluan ni San Larazo. But his vanquishing ended when he tried to conquer Mactan where a brave leader fought him to death named Lapu-Lapu. Miguel Lopez de Legazpi made the first permanent Spanish settlement on Cebu in 1565. In 1571, the islands were renamed in honor of King Philip II. He named the island as Felipinas and the capital was moved to Manila.The name was later changed into Philippines. A governor-general responsible to the viceroy of Mexico headed the colonial administration, but the parish priest was often the only visible symbol of Spanish authority in rural areas, and religious orders controlled education and many great estates. The Spanish came into conflict with the expanding Muslim population and eventually pushed them back to the southern islands, although neither Spain nor the United States at a later date was ever able to subjugate the Muslims completely.The Spanish occupation was inseparably linked with the missionary work of the Roman Catholic church. Trade in Chinese luxury items, gathered in Manila and sold in Acapulco in exchange for silver, was the economi c foundation of the colony until the 19th century, when the independence of Spain's New World colonies forced a shift to the cash-crop economy that persists to this day. In the 1880s a nationalistic movement developed, strongly influenced by the writings of Jose Rizal (1861-96). He spurred Filipino demands for reform.Rizal's execution made him a martyr and the country's national hero and sparked an unsuccessful revolution led by Emilio AGUINALDO. On June 12, 1898, after the outbreak of the Spanish-American War, Aguinaldo declared the Philippines independent in the mistaken belief that the United States supported his struggle. Instead, Spain ceded the Philippines to the United States. In 1899 until his capture in 1901 Aguinaldo led a war against his country's new colonial rulers.Although U. S. business interests applauded the seizure of the Philippines, the U. S.  government declared that it would prepare the islands for independence. In 1935 the Philippines became a self-governing commonwealth under President Manuel Luis Quezon, but World War II delayed full independence. Japan attacked the Philippines on Dec. 8, 1941, defeating U. S. and Filipino forces at Bataan and Corregidor in 1942. The struggle against Japan, culminating in Gen. Douglas MacArthur's return in 1944, came to symbolize U. S. -Philippine solidarity. On July 4, 1946, the Philippines gained full independence with Manuel Roxas y Acuna as president.After World War II, the economic and social infrastructure of the Philippines was a shambles. Inadequate land distribution and unequal taxation fed the Hukbalahap (Huk) guerilla revolt against the government, which was defused in the early 1950s by a resettlement and amnesty program devised during the presidency of Elpidio Quirino by Ramon Magsaysay, who became president in 1953. Ferdinand Marcos became the first president to win (1969) a second term after defeating President Diosdado Macapagal in 1965. In 1972, facing a Muslim revolt in the south, a leftist rural insurgency, and student unrest, Marcos declared martial law.He restored law and order, promoted social and economic reforms (often at the expense of his political foes), and created a political machine that remained dominant after martial law was lifted in 1981. Critics charged that he also enriched himself and his friends at the expense of the country. On Aug. 21, 1983, Marcos' chief political rival Benigno S. Aquino, Jr. , was assassinated as he returned to the Philippines from exile. Marcos loyalists were accused of complicity in the killing, which touched off waves of popular protest.The opposition gained in the 1984 legislative elections and a left-wing insurgency grew steadily, fueled by government repression and a declining economy. To renew his mandate, Marcos called early presidential elections, which were held on Feb. 7, 1986. Opposition leader Corazon Aquino and her running mate Salvador Laurel were backed by much of the business community and the influenti al Roman Catholic Church. When the National Assembly declared Marcos the victor amid widespread charges of electoral fraud, Aquino launched a campaign of nonviolent resistance to secure the post many believed she had won.On February 22, when defense minister Juan Ponce Enrile and army deputy chief of staff Lt. -Gen. Fidel Ramos resigned, huge crowds of ordinary Filipinos turned out to protect the dissident military leaders, and the United States increased its pressure on Marcos to step down. On February 25, after Marcos and Aquino held rival inaugurations, Marcos left for exile in the United States, which quickly recognized Aquino as president. Aquino took steps to restructure the government and the military, restore civil liberties, promote free enterprise, and retrieve public monies illegally appropriated by Marcos and his cronies.She freed political prisoners, announced her desire to negotiate with leftist leaders, and agreed to honor the treaty allowing the United States to oper ate military facilities at Clark Air Base and Subic Bay Naval Base. Despite popular support, however, Aquino faced formidable problems. These included the Communist insurgency, the weak economy, widespread social injustice, continued opposition from Marcos backers, and squabbles within her own diverse coalition. Unable to reach a negotiated settlement with Communist insurgents, she was also criticized for failing to halt corruption.Marcos died in 1989, but many former allies, including former defense minister Juan Ponce Enrile challenged her and Vice President Salvador Laurel, who resigned as foreign minister in 1987 and was named head of the opposition Nacionalista party in 1989. In December 1989, after the most serious of several coup attempts by dissident soldiers was quelled with U. S. military aid, a six-month limited state of emergency was declared. Aquino survived a seventh coup attempt in October 1990.In 1991 the eruption of Mount Pinatubo forced the United States to abandon Clark Air Base, and the Philippine Senate rejected a new 10-year lease for the country's remaining U. S. military facility, Subic Naval Base, weakening the historic ties between the two countries. Defense minister Fidel Ramos, a long-time Aquino supporter who helped her survive seven coup attempts by dissident soldiers, won a seven-way presidential contest in May 1992 with only 23. 5% of the vote. He assumed the presidency on June 30.The last of the U. S.  military and naval units were withdrawn from the Philippines in November, ending a presence that had existed since 1898. Mount Mayon, a volcano situated 330 km (205 mi) south of Manila, erupted in February 1993. He fought for the Philippines 2000 Tiger Economy. His term brought about a progress to the Philippines. The Asia Pacific Economic Congress (APEC) was held in the Philippines during his term. Replacing him was the present President Joseph Ejercito Estrada. Winning the May 11, 1998 election, many controversies arises and Filipinos looking forward to a better future having him as the new president.

Thursday, January 2, 2020

Dominance In The Yellow Wallpaper - 1850 Words

Logically, we must first analyze the nature of these women’s personal confinements and establish that their marriages were, in fact, prison-like in design. In â€Å"The Yellow Wallpaper†, female author Charlotte Perkins Gilman develops a clear power dynamic between her main character, Jane, and her husband, John. Meant to aid as a representation of all/most of men in marriage, John’s tendency to assert entitled dominance over Jane indicates the overall tendency of marriage to encourage male superiority. As Jane explains why they happened to recently move into their current house, mainly due to her â€Å"nervous condition†, she asserts that despite him being a doctor, â€Å"John does not know how much [she] really [suffers]. He knows there is no reason†¦show more content†¦After Mrs. Mallard has been told that her husband is dead, she has the expected and typical reaction of breaking down and crying. When she locks herself in her room, however, ev en after attempting to â€Å"beat it back with her will†, a sense of relief rushes over her as she realizes that â€Å"there [will] be no [longer a] powerful will bending hers in that blind persistence with which men and women believe that they have a right to impose a private will upon a fellow creature† (Chopin). Though she attempts to resist the urge to express her happiness at her husband’s death, she finds it impossible. She even needs to consciously resist the trivial thoughts, as she attempts to â€Å"beat it back†, due to the fact that rationality says a wife should mourn the death of her husband. Despite this expectation, she eventually allows herself to admit that life may actually be better without her husband, displaying that the comfort that men experience in marriage is not shared among their wives. To the surprise of no one, the women in dominating marriages do not tend to enjoy the lack of power that they are yielded. Mrs. Mallard describe s her husband s prior influence on her as â€Å"powerful† and â€Å"bending†, suggesting that she realizes the presence of a clear power gradient, and that theShow MoreRelatedVictims of Male Dominance in a Rose for Emily and the Yellow Wallpaper1670 Words   |  7 PagesVictims of Male Dominance The trails and tribulations of life can cause a person to go down a road they could have never imagined. Some people are able to rise above the issues that come their way and while others become consumed by their problems. In a male dominated society, the issues of women are often pushed to the side and they are left to deal with them alone. 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