...In order to maintain balance and avoid unnecessary destruction of tissue, protease inhibitors such as alpha-antitrypsin exist in the body (Leischner, n.d.). The main pathologic process in emphysema is caused by a combination of injury by irritant substances and a deficiency of protease inhibitors. Irritants affect protease inhibitors by hampering their protective function of the lung tissue and causing inflammation that ultimately destroys the tissue (Prendergast, 2010). The most common irritant that causes emphysema is cigarette smoking, but there are others such as occupational dust and chemicals, pollution, second hand smoking, and combustion fumes (McPhee et al.,...
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...Bartling vs. Superior There are many health care cases that are going on in the world. The Bartling vs. Superior case occurred around November 6, 1984 when William Bartling expired. Bartling had been suffering from pulmonary emphysema, atherosclerotic cardiovascular disease, coronary arteriosclerosis, abdominal aneurysm, and lung cancer. The patient was forced to use a ventilator against his wishes. A ventilator was needed to help him breathe or he would have not lived as long as he had. The ventilator was attached by a tracheostomy. “Mr. Bartling entered Glendale Adventist on April 8, 1984, for treatment of his depression. A routine physical examination, including a chest X-ray, was performed, and a tumor was discovered on Mr. Bartling's lung.” (LexisNexis, 1994.) There was a biopsy performed by inserting a needle into the left lung, which caused the lung to collapse. The physicians had to insert tubing through his chest and nasal passage to try and inflate. The lung was unsuccessful in being inflated due to the fact that the patient had previous history of emphysema. By this time, Mr. Bartling is put on a ventilator to keep him alive. The patient asked multiple times to have the ventilator removed but the facility denied his request. He also had tried taking the ventilator out himself. The facility then had to restraint Bartling from hurting himself even more. The patient’s wife and daughter had brought in William’s living will and his wishes. In his will it stated, "If at...
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...home after the previous governess died. Douglas begins to read from the written record, and the story shifts to the governess’s point of view as she narrates her strange experience. The governess begins her story with her first day at Bly, the country home, where she meets Flora and a maid named Mrs. Grose. The governess is nervous but feels relieved by Flora’s beauty and charm. The next day she receives a letter from her employer, which contains a letter from Miles’s headmaster saying that Miles cannot return to school. The letter does not specify what Miles has done to deserve expulsion, and, alarmed, the governess questions Mrs. Grose about it. Mrs. Grose admits that Miles has on occasion been bad, but only in the ways boys ought to be. The governess is reassured as she drives to meet Miles. One evening, as the governess strolls around the grounds, she sees a strange man in a tower of the house and exchanges an intense stare with him. She says nothing to Mrs. Grose. Later, she catches the same man glaring into the dining-room window, and she rushes outside to investigate. The man is gone, and the governess looks into the window from outside. Her image in the window frightens Mrs. Grose, who has just walked into the room....
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...character? To what extent is her final protest justified? How do the other characters portray themselves by their attitudes toward the ritual? Mrs. Tess Hutchinson stands out right from the start: she arrives at the lottery late. She explains to Mr. Summers that she was doing her dishes and forgot what day it was. The town treats her lateness lightly, but several people comment on it, “in voices just loud enough to be heard across the crowd, ‘Here comes your Missus, Hutchinson,’ and ‘ Bill, she made it after all.’” (Jackson 501). It is ironic that she is the one who wins the lottery, and is fated to be stoned. So Tess Hutchinson has already been noticed by people as one who is not entirely part of the group. Before the drawing she is friendly with the other women, pretending to be pleased to be present. The very moment that she sees is her family that draws the black dot, though, her egotism is evident. “You didn’t give him time enough to take any paper he wanted. I saw you. It wasn’t fair!” (Jackson 504). She continues to scream about the unfairness of the ritual up until her stoning. Mrs. Hutchinson knew the lottery was wrong, but she never did anything about it. She pretends as much as she could to enjoy it, when she truly hated it all along. Maybe Jackson is suggesting that the more hypocritical one is, the more of a target they are. Mrs. Hutchinson was clearly the target of her fears. I think sometimes we have no problem remarking on people’s adultery until it is ourselves that...
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...118; so subsequent A1C was drawn and that was found to be 6.1. Unfortunately she had gone ahead and left prior to getting the A1C. Assessment: hypertension, hyperlipidemia, new onset boarder line diabetes. Plan: need to contact her about this finding, and discuss the implication, we’ll adjust medicines as needed when her labs come back and follow up in 3 months. Patient #2 ...little more trouble doing this one, had trouble, patient doing quite well, overall... lungs mostly full with hollow expansion, no edema, but PFT is 1.65 liters which is 63% atrophy which is 83% of patient, which is slightly worse compared to last PFT which was 1.83 liters..... mildly worsening lung functions. Plan: at this point I would like to continue to watch her and see her back in 6 weeks, if lung functions remain low then start her on Prednisone pills. I would like to wait to see whether its just the season or not. Wait until follow-up. Patient #3 Right totally arthroplasty wound, multifactorial...Crohn’s Disease. Mr. Fields returns today in follow-up period, he has been doing well on oral avelox following removal of his right knee arthroplasty for his suspected infection period; he has had no positive cultures for any likely pathogens from his operative cultures. He was discharged on avelox with the suspicion that his non-healing wounds are more likely related to the imuran...
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...members and the spirited PTA Officers. J & M: ladies and gentlemen, good evening! Welcome to the search for MISS SSG 2011-2012 and the induction ceremony of Tugdan National High School. M: as we commence this momentous event, may I request everybody to rise for a soul warming doxology to be lead by selected students. J: please remain standing for the Philippine National Anthem to be conducted by Mrs. Rachel Fesalbon. M: the world is proud of having its great leaders. From ancient times up to present, good leaders foster the rest of the world to stand firm, to dream big and to take the highest flight man could ever take.. good leaders prepare people to survive the realities of life !ladies and gentlemen, let us hear from our loving Madam Melicia Galicia for her opening remarks. : and at this moment, may I call on Mr. Christian Solidum to introduce the board of judges for tonight’s affair. J: thank you sir! And now let us all welcome our candidates in their production number. J: now, we have the induction ceremony of the newly elected SSG Officers who will be presented by Mr. Randy A. Musa, SSG Adviser and to be inducted by Hon. Herman Galicia, ABC President.. may I request all the officers to come on stage. M: folks, let us be entertained as the selected students set on stage in their modern dance presentation. : thank you guys!! J: ladies and gentlemen, a big round of applause to the candidates in their fashionista...
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...May I beg that you will write at once to the mother of this unfortunate woman--to Mrs. Catherick--to ask for her testimony in support of the explanation which I have just offered to you?" I saw Miss Halcombe change colour, and look a little uneasy. Sir Percival's suggestion, politely as it was expressed, appeared to her, as it appeared to me, to point very delicately at the hesitation which her manner had betrayed a moment or two since. I hope, Sir Percival, you don't do me the injustice to suppose that I distrust you," she said quickly. "Certainly not, Miss Halcombe. I make my proposal purely as an act of attention to YOU. Will you excuse my obstinacy if I still venture to press it?" He walked to the writing-table as he spoke, drew a chair to it, and opened the paper case. "Let me beg you to write the note," he said, "as a favour to ME. It need not occupy you more than a few minutes. You have only to ask Mrs. Catherick two questions. First, if her daughter was placed in the Asylum with her knowledge and approval. Secondly, if the share I took in the matter was such as to merit the expression of her gratitude towards myself? Mr. Gilmore's mind is at ease on this unpleasant subject, and your mind is at ease—pray set my mind at ease also by writing the note." "You oblige me to grant your request, Sir Percival, when I would much rather refuse it." With those words Miss Halcombe rose from her place and went to the writing-table. Sir Percival thanked her, handed her a...
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...He went to where Miss Mijares sat, a tall, big man, walking with an economy of movement, graceful and light, a man who knew his body and used it well. He sat in the low chair worn decrepit by countless other interviewers and laid all ten fingerprints carefully on the edge of her desk. She pushed a sheet towards him, rolling a pencil along with it. While he read the question and wrote down his answers, she glanced at her watch and saw that it was ten. "I shall be coming back quickly," she said, speaking distinctly in the dialect (you were never sure about these people on their first visit, if they could speak English, or even write at all, the poor were always proud and to use the dialect with them was an act of charity), "you will wait for me." As she walked to the cafeteria, Miss Mijares thought how she could easily have said, Please wait for me, or will you wait for me? But years of working for the placement section had dulled the edges of her instinct for courtesy. She spoke now peremtorily, with an abruptness she knew annoyed the people about her. When she talked with the jobless across her desk, asking them the damning questions that completed their humiliation, watching pale tongues run over dry lips, dirt crusted handkerchiefs flutter in trembling hands, she was filled with an impatience she could not understand. Sign here, she had said thousands of times, pushing the familiar form across, her finger held to a line, feeling the impatience grow at sight of the man...
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...Contact Information for Teaching Staff at Thomas Knyvett College If you email a member of staff please allow 48 hours for a response. If it is an urgent matter please contact a member of the SLT or your son/daughter’s House Leader. Senior Leadership Team Mrs Miss Mr Mr Mr Miss Mrs Mrs Mrs Miss Miss Mr Mrs Mrs Ms Mr Mrs Mrs Mrs Miss Miss Miss Miss Mrs Mr Miss Mrs Miss Miss Mr Ms Ms Mrs Mrs Miss Mrs Mrs Miss Mr Mrs Mr Mrs Mrs Miss Miss Miss Ms Miss Miss Miss Mrs Janise Farrah Andrew Sheldon Chris Freya Claire Valerie Inma Seema Allison Adam Sian Kapila Theresa David Aimi Correen Jackie Emma Tanya Joann Alison Rachel Nick Abigail Wendy Lauren Isobel Andy Megan Mazie Carolyn Priscilla Preetpal Gurinder Sian Emily Steven Christine David Susan Vanessa Hayley Jean Azmari Linda Laura Nicole Hayley Tanya Marillat Thantrey Ward Snashall Bellamy Oliver Parsons O’Keeffe Alvarez Balrai Bates Belbin Bolsh Chalisgaonkar Chambers Chapman Curtis Danks Dillaway Edge Ellis Epps Fairclough Foley Fowler Frith Grantham Jankowski John Knott Lister Lloyd-Smith Manwaring Naicker Nashad Oberai Reeve Razzell Ratsakatika Reilly Retsinas Rowntree Russell Sculpher Semadeni Shikder Strachan Thomas Vernon Warren Zaheer JMa FTh AWa SSn CBe FOL CPa VOk IAL SBa ABa ABe SBo KCh TCh DCh ACs CDa JDi EEd TEl JEp AFa RFo NFo AFr WGr LJa IJo AKn MLi MSm CMa PNa PNd GOi SRv ERa DRa CRe SRe SRe VRu HSc JSe ASh LSt LTh NVe HWa TZa Head of School Deputy Head Assistant Head Assistant Head Cross Phase Assistant Head Partnership...
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...Article 86 of the Uniform Code Of Military Justice. This Article covers Point and Place of Duty. That means from PT formation to COB that is where you will be. What a lot of Soldiers do not understand that includes appointments made by them or someone else. We have appointment times, SP times, formation times and many other start times that dictate we will be there. If a Convoy has an SP time of fifteen hundred hours and the Soldiers decide to show up late because they did not feel like getting ready on time people could die. If they rolled out on time, they may have avoided the ambush or avoided the Vbid that hit them in the bottleneck. It sounds extreme but time management plays a critical role in the Army. When you make an appointment that spot has been reserved for you. That means if you have been given the last slot someone else is going to have to wait for another one to open up. This could be one day or one month. And because you missed it someone else is still going to have to wait when they could have had that spot and been there. If you are going to miss the appointment or cannot make it due to mission they do allow us to cancel the appointment with in twenty four hours. The Army allows us to make appointments for whatever we need. Be it for a medical appointment, house goods, CIF, Smoking Sensation or whatever we need these recourses are available to us. But when Soldiers start missing appointments theses systems start to become inefficient. What a lot of Soldiers do...
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...THE VIRGIN by Kerima Polotan Tuvera 1) He went to where Miss Mijares sat, a tall, big man, walking with an economy of movement, graceful and light, a man who knew his body and used it well. He sat in the low chair worn decrepit by countless other interviewers and laid all ten fingerprints carefully on the edge of her desk. She pushed a sheet towards him, rolling a pencil along with it. While he read the question and wrote down his answers, she glanced at her watch and saw that it was ten. "I shall be coming back quickly," she said, speaking distinctly in the dialect (you were never sure about these people on their first visit, if they could speak English, or even write at all, the poor were always proud and to use the dialect with them was an act of charity), "you will wait for me." As she walked to the cafeteria, Miss Mijares thought how she could easily have said, Please wait for me, or will you wait for me? But years of working for the placement section had dulled the edges of her instinct for courtesy. She spoke now peremtorily, with an abruptness she knew annoyed the people about her. When she talked with the jobless across her desk, asking them the damning questions that completed their humiliation, watching pale tongues run over dry lips, dirt crusted handkerchiefs flutter in trembling hands, she was filled with an impatience she could not understand. Sign here, she had said thousands of times, pushing the familiar form across, her finger held to a line, feeling...
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...was a member of the “Kissy girls”, whose job was to hunt boys down and kiss them till they screamed. Another hobby was to collect snakes and lizards. She even had a favourite lizard, called Vladimir. Later she was a student at Beverly Hills High School far from being beautiful. She wore braces, glasses and was painfully skinny. So the students teased her but they didn’t know that she had an impressive collection of knives. Her movie career At the age of seven she appeared in her first movie but her breakthrough came with Girl, Interrupted. It followed her big hit: her role in Tomb Raider, where she had to master a British accent. She had to become familiar with kick-boxing, street-fighting, yoga and ballet. In 2005 she released Mr. and Mrs. Smith, where she and Brad Pitt starred as a bored couple. Now she is married with Brad Pitt and although she is committed to motherhood she does charitable work...
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...When most people see the name Angelina Jolie they only think of the talented actress, the significant other of Brad Pitt or the celebrity with the very diverse children but she is so much more than that. Since 2001 Jolie has been working alongside the United Nations High Commissioner for Refugees to bring awareness to the unfortunate situations of refugees from around the world. She has traveled to and volunteered in many third world countries such as; Sierra Leone, Cambodia, Costa Rica, Iraq and North Caucasus. In addition to this, she along with Brad Pitt founded the Jolie-Pitt foundation which is dedicated to eradicating extreme rural poverty, protecting natural resources and conserving wildlife. This foundation also donates to many other humanitarian groups, one being Doctors without Borders. In 2009 Angelina Jolie gave the opening speech for a World Refugee Day event being held at the National Geographic Society headquarters in Washington D.C. Throughout this speech Jolie concentrates not on the horrible conditions that refugees endure but on the spirit that they have from being in these situations. When speaking to millions of Americans she doesn’t rely on facts or statistics but instead she uses anecdotal evidence, visualization and pathos to get her point across. The purpose of this speech is not to persuade but to inform the people of America about the amazing people she has met while traveling to third world countries. Furthermore, she is trying to show people that...
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...When most people see the name Angelina Jolie they only think of the talented actress, the significant other of Brad Pitt or the celebrity with the very diverse children but she is so much more than that. Since 2001 Jolie has been working alongside the United Nations High Commissioner for Refugees to bring awareness to the unfortunate situations of refugees from around the world. She has traveled to and volunteered in many third world countries such as; Sierra Leone, Cambodia, Costa Rica, Iraq and North Caucasus. In addition to this, she along with Brad Pitt founded the Jolie-Pitt foundation which is dedicated to eradicating extreme rural poverty, protecting natural resources and conserving wildlife. This foundation also donates to many other humanitarian groups, one being Doctors without Borders. In 2009 Angelina Jolie gave the opening speech for a World Refugee Day event being held at the National Geographic Society headquarters in Washington D.C. Throughout this speech Jolie concentrates not on the horrible conditions that refugees endure but on the spirit that they have from being in these situations. When speaking to millions of Americans she doesn’t rely on facts or statistics but instead she uses anecdotal evidence, visualization and pathos to get her point across. The purpose of this speech is not to persuade but to inform the people of America about the amazing people she has met while traveling to third world countries. Furthermore, she is trying to show people that...
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...McClellen The Dangers of Gastric Bypass and Lap-Band Procedures As with any surgery, gastric bypass and lap-band procedures pose potential health risks. One danger with the gastric bypass procedure is a condition known as “dumping syndrome”, this is where ingested foods bypass the stomach too rapidly and enter the small intestine largely undigested. This undigested food draws excessive fluid into the small intestine causing nausea, cramping, diarrhea, sweating, feeling faint and fast heart rate. In addition people with this syndrome often suffer from low blood sugar or hypoglycemia. Blood clots in the legs can be another danger: In some cases they travel to the lungs and lodge in the arteries which could cause a pulmonary embolism, a serious condition that damages lung tissues and can even lead to death.(“Gastric Bypass Surgery” ,2007) The lap-band procedure also has dangerous risks, one being: Infection of Surgical wounds, or deep abdominal infections because of manipulation of the bowel and organs with the added potential of damaging of bowels and releasing contaminated contents into the stomach. Another risk is the slipping of the band from its original position, if this were to occur then the surgical procedure would be necessary to be performed again. (Chrisholm, 2011) 2 References Mayo Clinic (2007, Oct 5). Gastric Bypass Surgery: What to expect? Retrieved July 17, 2013 from CNN Health website: http://www.cnn.com/health/library/gastric ...
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