Essay on Mechanically Ventilated Patients, An Annotated...

Review of literature Monnet et al(1) published a review article on assessment of volume responsiveness in mechanically ventilated patients using heart and lung interactions. He explained that mechanical ventilation produces cyclic changes left ventricular stroke volume due to inspiration and expiration induced changes in LV preload. It denotes preload dependency of left ventricle indirectly right ventricle. He also describes various limitations of respiration variations in SV for predicting fluid responsiveness. Guidet et al(2) conducted a study in sepsis patients to find haemodynamic efficacy and safety between 6%HES 130/0.4 vs 0.9% NaCl. He found that volume requirement was less with HES than NaCl in inial phase of fluid†¦show more content†¦He found that there was less colloid consumption, less hypotension episodes and lower lactate level at end of surgery in vigileo group. He concluded that haemodynamic stability was better when SVV was used a guide for fluid optimization. Fiessel M et al(5) related fluid responsiveness and respiratory variation in inferior vena cava diameter in mechanically ventilated patients with septic shock. He induced volume change by loading patients with 8ml/kg of colloid solution. Changes in IVC diameter and cardiac output were measured using echography before and after volume loading. 15% increase in Cardiac output post volume loading were called as responders. 16 out of 39 pt responded to fluids and he has given 12% delta IVC cut off for detection those volume responders. Stawicki SP et al(6) studied the correlation between inferior vena cava collapsibility index(IVC-CI) and central venous pressure(CVP). They used intensivist-performed bedside ultrasonography(INBU) for assessing IVC-CI. They divided the patients into three groups based on IVC-CI (0.20,0.20-0.60 and 0.60). They concluded that IVC-CI correlate well with CVP in low(0.20) and high(0.60) collapsibility ranges. Nagdev et al(7) conducted a study to find that greater than or equal to 50% increase in caval index is associated with CVP 8 mmHg. The study was done among adult patients undergoing centralShow MoreRelatedTransference and Counterference3996 Words   |  16 Pagesphenomena that may arise during the course of the therapeutic relationship. Understanding these phenomena in nursing is important because the primary focus of nursing is the nurse-patient relationship (Imura, 1991). This discussion will describe how these phenomena occur, and how they may manifest in the nurse-patient relationship. Furthermore, this discussion will highlight nursing interventions in these situations, in order to provide insight into how nurses can maintain and improve the therapeuticRead MoreWatsons Theory of Human Caring2041 Words   |  9 Pageshuman caring. The utilization of Watson’s theory of human caring is extremely relevant within the critical care arena, specifically because of the high acuity of the patient population. The practical application of this theory is explored utilizing several important elements to describe a personal interaction between the patient populations. The Caring Moment Defined Watson (2012) defines the caring moment as, â€Å"An actual caring moment occasion involves action and choice both by the nurse and

Federalists and Anti-Federalists Essay - 1665 Words

The Constitution, when first introduced, set the stage for much controversy in the United States. The two major parties in this battle were the Federalists and the Anti-Federalists. The Federalists, such as James Madison, were in favor of ratifying the Constitution. On the other hand, the Anti-Federalists, such as Patrick Henry and Richard Henry Lee, were against ratification. Each party has their own beliefs on why or why not this document should or should not be passed. These beliefs are displayed in the following articles: Patrick Henrys Virginia Should Reject the Constitution, Richard Henry Lees The Constitution Will Encourage Aristocracy, James Madisons Federalist Paper No. 10, and The Letters to Brutus. In these†¦show more content†¦He thinks that this system would never really be followed. The senate, he says, is not structured well enough to protect the rights of the people. One of his main points is the leaning towards a monarchy. He describes that it would be very easy for the President to become a king. Henry seems to also contradict himself on this point when he says that he would rather have a king and lords than a chief who controls the army. Henrys final point is about the creation of an absolute ruler. Like he says about the monarchy, it would be easy for this to happen. If the President has control of the army, it would be easy to declare himself an absolute leader. Richard Henry Lee is another Anti-Federalist who displays his views throughout his article. Lee discusses some arguments, but the main point of his article is about how the Constitution came to be and the problems associated with it. He says by making tender, suspension, and paper money laws, have given just cause of uneasiness to creditors. By these and other causes, several orders of men in the community have been prepared, by degrees, for a change in government (Lee in Unger, p. 119). Lee believes that if these things had not occurred, the idea of a new government would have never been thought of. Another point that Lee makes is about the delegates that were chosen to go to the convention. He says that the intentional purpose of the convention was to amendShow MoreRelatedThe Federalist And Anti Federalist1263 Words   |  6 Pages The Anti-Federalist put up a long and hard fight, however, they were not as organized as the Federalists. While the Anti- Federalist had great concerns about the Constitution and National government, the Federalist had good responses to combat these concerns. The Federalist were and for the Constitution and feel the Article of Confederation were not worth ratifying, these should be scrapped altogether. They felt that the Articles limited the power of congress, because congress had to request cooperationRead MoreThe Federalist And The Anti Federalist864 Words   |  4 Pagesthe federalist, then later on the anti-federalist in 1796. Alexander Hamilton was the leader of the federalist party. Thomas Jefferson was the leader of the anti-federalist; who called themselves the Democratic-Republicans. Our first president, George Washington warned us about having parties and the danger of them. However, not until Congress debated the ratification and implementation of Jay’s Treaty wit h Great Britain did two political parties clearly emerge; the Federalist and the Anti-FederalistRead MoreThe Federalists And The Anti Federalists1189 Words   |  5 PagesIn debate of the ratification of the Constitution, the Federalists and the Anti- Federalists agreed on several things: the necessity of some form of national government, the preservation of the right to vote, and the need to secure our liberties. The Federalists wanted a strong central government, whereas the Anti- Federalists wanted more power reserved to the state government. The right to vote is important for both sides, but they hold conflicting views on the amount of involvement through theRead MoreThe Federalists And The Anti Federalists1656 Words   |  7 Pagesarticles defending their positions. They were named the Federalists and the Anti-Federalists. The Anti-Federalists, however, were incredibly displeased with the name that the Federalists had coined for them. In that time, Federalism was synonymous w ith Confederation, which was what the Anti-Federalists were fighting to protect. The arguments were varied, and consisted of valid points from both sides. One of the major arguments of the Anti-Federalists was the supposed validity of a large scale republicRead MoreThe Federalists And The Anti Federalists1305 Words   |  6 Pagesthe cause for a huge debate between; The Federalists and the Anti-Federalists. The Federalists were those who thought that there should be a new Union created with a strong centralized government and individual regional governments. They felt that it was not necessary for there to be a bill of rights because it was implied that those rights the Constitution did not specifically state would be handed down to the states. On the other hand, the Anti-Federalists were opposed to such a form of governmentRead MoreFederalists Vs. Anti Federalists1518 Words   |  7 PagesIn early 1788, Federalists and Anti-Federalists held fierce debates over how the state of Rh ode Island would vote on Constitutional ratification. Two models of democracy were contested: the Anti-Federalists argued in favor of mass participation in the form of a state referendum, and the Federalists argued in favor of elite representation in the form of a state convention. On the whole, while the state referendum model used in the debates in Rhode Island allows for greater participation and an opportunityRead MoreFederalists vs. Anti-Federalists1723 Words   |  7 Pagesthe subject of numerous debates. The contending groups consisted of Federalists, those who supported ratification, and Anti-Federalists, those opposed to the constitution. Each group published a series of letters known as the Federalist and Anti-Federalist Papers. The Anti-Federalist papers objected to provisions of the proposed constitution while the Federalist Papers defended the rationale behind the document. Anti-Federalist objections included that; the United States was too extensive to beRead More The Federalists Vs. Anti Federalists1010 Words   |  5 Pagesduring the American Revolution. The rivalry between the Federalists and the anti-Federalists emerged during the process of ratifying the Constitution between 1787 and 1788. Initially, the Federalists supported the Constitution while the anti-Federalists did not (199). The principle differences dividing the Federalists and anti-Federalists were the controversy of creating a federal government and how to interpret the Constitution. Anti-Federalists insisted on protecting the rights of the states and theRead MoreAnti Federalists Vs. Federalists1634 Words   |  7 Pages Anti Federalists vs. Federalists (Paper #1) The Federalists and the Anti - Federalists played an indispensable part in the establishment of the American Constitution. Federalists were supporters of the constitution, while Anti federalist were against the ratification of the Constitution. Federalists believed in the idea of a larger heterogeneous republic whereas anti federalists wanted a small homogenous republic. Famous federalists like James Madison, John Jay and Alexander Hamilton are responsibleRead MoreThe Federalists Vs. The Anti Federalists1801 Words   |  8 Pagesare worse than others. In the case of the Federalists vs. The Anti-Federalists, was the drafting of the Constitution actually worth it in the end? When the colonists first came over seas from Great Britain there was one thing that was vastly agreed on—a change in how government works and runs was necessary for the future of America. Two major groups eventually formed behind this way of thinking, the Federalists and the Anti-Federalists. The Federa lists were under the impression that the formation

Lecture Notes Free Essays

Revenge Deterrence Get rid of them, get them of the streets Retribution Just desserts Justice, proportionate The punishment must fit the crime It must be proportionate Contravention of social order requires ‘pay back’ to society or volt Deterrence Threat of punishment will prevent future crime Hedonistic calculus If the pleasure out ways the pain deterrence is ineffective General Deterrence, and Specific You see a friend commit a crime and you don’t want to Specific Is you Certainty, Celerity, Severity These need to be close together In order for deterrence to be affective certainty Is he most important; if you are certain you are going to get caught, you wont do it. Does deterrence work? Sometimes it does work (they get out, and they don’t want to go back) and sometimes it doesn’t work (people sometimes bargain with the judge to get put into Jail longer, or they go back to crime) Incapacitation (Prison) Symbolic: denouncement of act communicated to offenders and society through use of punishment In the sense of freedom; we as people of society we value our freedom, and taking it away is tough on a lot of people Imprisonment, deprivation of liberty Remove problem elements from society Rehabilitation Address underlying causes facing the offender Focus on offender, not crime Assumes transformation potential of rehabilitation within a punitive context The problem with rehabilitation is that it believes that you can rehabilitate someone in a prison setting; where you got people in an anxious setting etc. ND it becomes a lot more challenging Justice Policies Trend in Policies There is more emphasis on incapacitation, retribution, deterrence Rehabilitation, re paration overshadowed Less focus on solving problems of crime Belief that vindictive punishment is most appropriate response to crime Trend in US ND Canada toward punitive approaches New Pensiveness From mid-sass’s Claim of global trend toward harsher CA sanctions More and more punishment is increased, some states in the U. We will write a custom essay sample on Lecture Notes or any similar topic only for you Order Now S have totally gotten rid of community sanctions and probation Increase use of prison, more crimes result in prison, increase prison lengths, mandatory minimums More and more punishment is increased, some states in the U. S have totally gotten rid of community sanctions and probation Shaming initiatives, austere prison regimes For example in Arizona they make their inmates wear pink suits Zero tolerance strategies Zero tolerance means they have to report everything even if it’s a push fight Three strikes legislation If you do two serious offences on the third serious offence you get a life sentence Use of capital punishment It does not have an effect on crime rates In Canada the death penalty did not have an impact on crime rates In states for the first two weeks it would go down and then it would go right back to where it was Harsh CSS policies are response to increasing public disorder, rising crime, deterioration of moral framework Leap backward, shift away from restraint Stretching the limits of punishment Tough Justice War on Drugs in 1971 Drug offences is what is driving the crime rates in the U. S out the roof Crack: is used by the lower class people Cocaine: is used by the middle and upper class The police are targeting the lower class that is using crack So the prisons and sanctions in the U. S is filled with the minority people, such as blacks and Latinist’s Tough on crime policies and election platforms 1980 = 40,000, 2008 = 500,000 Simon: prison used to target race Relationship between ‘Get Tough’ and Crime Rates Little relationship between crime and incarceration rates There is no relationship with how tough you are on crime and the crime rate. You can e as tough as you want but it will not put a dent on the crime rate. High welfare spending = low incarceration rates Greater inequality = higher incarceration rates Inefficient – move away from pensiveness Example: Texas vs†¦ California Texas spent a lot of money on offences, which in turn had zero effect on the crime rate, where as California spent no money, and they had the same rates as Texas who spent a lot of money Canada youth incarceration rate Canada put in place laws and barriers that stated you can’t put children under the age of 12 in Jail. Criminal Responsibility Category Age Children Under 12 None Youth 12-17 Diminished Adults 18+ Full Legal Legal Classification of Criminal Offences Offence Hearing Punishment Summary Provincial court Judge $2000 both Indictable (Felony: U. S term; both mean the same thing) Less serious: provincial court Judge Most serious: provincial superior court by federally appointed Judge All others: Judge without Jury Up to Life Hybrid Can be summary or indictable Prosecutor discretion Record, circumstances Varies Cocoas: Representations of Crime – Lecture 3 Non. 29) Epistemology – Study of knowledge What do we know about crime? How do we know what we know? How do we acquire our knowledge? What are its limitations? Common Sources News Word of mouth Problems with Understanding Crime Hidden Subject of inquiry is deliberately Insight Criminals have little insight into the broader nature of their behavior What does one murderer know about another Cost Access in costly, time consuming and partial Scope Much crime lies beyond the scope of research Access Sociologists cannot pass effortlessly into every situation Barriers exist within social worlds Representation Social worlds are not representative Official Sources of Crime Statistics The Crime Funnel Citizens detect crime A lot of people do not report crime, for reasons being: Fear Can resolve it on your own Police might/wont do anything about it May not think it’s a crime/don’t define it as a crime Street youth, they don’t trust the police because they are victimized If you are engaging in criminal behavior you won’t report crime to the police. Uniform Crime Reports Standardized counts of crime known to police National statistics about crime Applies standard definitions to all offences Counts used to determine crime rates The Canadian Centre for Justice Statistics Limitations Mainly the crime funnel Justice system does not give an accurate portrayal of crime Unreported crime The â€Å"dark figure† of crime Self-Report Surveys Asks people about the crimes they have committed You can get peoples attitude etc Who commits the most crime: Young Adults Identifies some unreported crimes (dark figure) Measure attitudes and prevalence of offending (primary peers) Factorization Surveys Asks victims about crimes they did not report Indicate that a large number of crimes are not reported Example: Canadian Urban Factorization Survey Direct Measures Economic loss, physical injury, property damage Indirect Measures Fear of crime and its effects People don’t want to be alone at night Lock the doors Establish new expectations and measurements for police effectiveness Increase understanding and trust between police and immunity leaders Empower and strengthen community-based efforts Commitment to long-term proactive prevention strategies Decentralized operations and management Develop new skills in police Racial and Criminal Profiling Racial Criminal Any action undertaken for reasons of safety, security or public protection, that relies on stereotypes about race, color, ethnicity, ancestry, religion, or place of origin, or a combination of these, rather than on a reasonable suspicion, to single out an individual for greater scrutiny or different treatment. Relies on actual behavior or on information about suspected activity by someone who tests the description of a specific individual. What is Racial Profiling? Based on stereotypical assumptions because of one’s race, color, ethnicity, etc. Evidence of disproportionate stops When is it profiling? B, women in spousal relationship killed, airport Good police work or self-fulfilling prophecy â€Å"Intuition†, â€Å"suspicion† Visibility, definition If you are a young black male with an education you are more likely to be stopped by police. ** By in large police officers in Canada are intelligent hard working people who want to serve Justice to the general public. ** How to cite Lecture Notes, Papers