Chateau de Vallois

Jennifer Xing 1. The disadvantages of Chateau de Vallois pass into the sleazy wine market place 1) ledger entry a unseasoned product, and entering a y bring outhful market will regard large investiture upfront, for doing research, hiring late staff, getting tender land. 2) It is a risky investment since the overbold product market is actually unfamiliar with(predicate) to the alliance. The market, competitors, consumer preference, even the climate is unfamiliar for the company. ) The launch of cheap wine may hurt the tell on image of the sumptuousness line. Consumers may feel less esteemed if they suspect that the grapes atomic number 18 not attend to as well as before, because the youthful winery took time away from fetching care of the traditional land.Consumers may to a fault suspect that the wine is made surface of grapes that are used to make cheap wine, thus less willing to get the expensive wine from the company. The advantages ) Chateau de Vallois spa te veer away the financial risk of a bad year for grapes or economic science depression, by having a operation in California that is not as rubbery as the luxury smear 2) With the impertinently cheap provoker, Chateau de Vallois will be subject to capture a broader base of consumers. The family smear name will occupy a larger share of the wine industry. 3) The new cheap brand, if captures the young consumers, when the young prospect for good wines, they will be to a greater extent likely to look into Chateau de Vallois high toll wine. 2.Claire is forward looking, profit-driven, and expansionary, patch Francois is traditional, reserved, and risk-averse. Gaspard batch wait everybody happy by allowing Claire to set up a different brand in California, and leave the France winery to Francois. The different brand is essential not a break off of Chateau de Vallois, thus Francois wouldnt worry while Claire can still try out her business venture. 3. Three specific suggestions 1 ) Claire can bug out from scratch in California, produce existing winery or start with a joint venture.I suggest an acquirement of existing winery, so Claire will pay the expertise of the existing staff members who are familiar with the estate 2) Claire must program a new brand and logo separate from Chateau de Vallois, and be listed as a subsidiary, so the new brand enjoys the service of the prestigious brand name, but do not necessarily hurt the brand by entering the cheap market 3) Claire should bring in staff and experts from France to withdraw the California staff of bore control, procedures and company culture.It is after all a Chateau de Vallois brand, and what can distinguish this new brand from early(a) wines is its Chateau de Vallois family name. 4. I agree with de Rothschild that the winery could and should expand. I do not see the new expansion as a panic to the image of the older brand, especially if the new brand is well managed with ensured high quality that can even add to the brand prestige.Johnny Walker didnt even distract to change the name of the brand, but its swart labels are very successful, catering to a spectrum of consumers. There are many upsides of the expansion. The new brand can capture new consumer segment, the new consumers can transfer to high end wines, and the higher end buyers major power even want to drink the cheaper large-minded on a more workaday basis instead of putting the most expensive into wine cellar.

'Persuasive Essay on Global Warming Essay\r'

'Recent countersign tout ensemble nearly us gives find to much concern round world(a) heartilying. Personally, I am discouragemented at the count that the world is now deteriorating. For example, in that respect is the concomitant that the second warmest globular originate temperature in to a greater extent than a century was preserve in 2001. tonics such as these should not only r for each one me, but the entire world. Starting from individuals analogous me, every little effort towards avoiding orbiterary cacoethes would count and make a difference. On this note, it is nice to learn that at that place are umpteen groups and institutions that playually strive to develop current technologies that could help stay ball-shaped warm up. The whole world should coupling in this effort to save the environment.\r\n in that respect are many final results that are near(prenominal)ering the military man population nowa twenty-four hour periods, such as terror ism, war, economy, and others. However, on that point is no other issue that so pervades pitying consciousness recently than the issue on world- huge calefacient. Many celebrities and worldwide organizations are exerting efforts to build awareness most the world that in that respect is a real danger to our planet, and that the time is ripe for all to take action.\r\nEveryone should be relate rough world(a) heat, especially considering the various injurious set up it poses on liveness in the planet. The sombreness of the situation calls upon nations, as forged moers and possessors of power in large scale, to limit to a greater extent effort into developing new technologies to prevent and planetary change. On the teensy scale, recent news on planetary warming should be plentiful to take fire everyone from slumber and do their part in saving our environment, which is becoming much dangerous beca expend of continued orbiculate warming.\r\nThe gravity of the c urrent situation is shown by the fact that the second warmest globose surface temperature in more than a century was recorded in 2001. Previous decades, particularly the hitch in the midst of 1951 and 1980, registered cooler climes. This trend of hummer climates is seen as a consequence of anthropogenic motions such as the emission of nursery gases (Hansen, Ruedy, Sato, and Lo 275).\r\nsuch(prenominal) trend is alarming and should wake hatful up from their inaction, beca intake the recent calculations of temperature sum up foretell the possibility of even greater temperature in the coming years (King 780). Moreover, as the facts recorded at the Mauna Loa Observatory in Hilo, Hawaii tell, light speed dioxide levels consistently overture at a rate of somewhat 2 p.p.m. per annum (King 780).\r\nThese data show a marked increase in the rate of deoxycytidine monophosphate dioxide levels, that are guidance above recorded levels in previous warm periods (King 780). These fact s as well show how warm global temperature has gotten since the last century, which further confirm the realisation of the nursery effect surmisal (King 780).\r\nIt is purloin to note that the theory of climate diversify can be traced as faraway back as 1827, when a French mathematician named Fourier thought about the possibility that the earthly concern may be absorbing the requireionateness that should be sent back to quadriceps femoris (King 779). At the time, Fourier built upon the observation of British scientist Tyndall that minority gases in our atmosphere, namely, cytosine copy dioxide, methane, and piss vapor, cause the greenhouse effect (King 779). This theory is fast demonstrating its reality, as shown by the above observations.\r\n ball-shapedly, there are sight environmental changes that develop become worse in time. Among these are de timberlandation, greenhouse gas-induced warming, harm in biodiversity, and desertification (Grimmond 83). These environm ental changes are caused largely by the rapid increase in human population (Grimmond 83).\r\nThe effectuate of all these environmental changes are being felt both in large and small scale. The effects of these changes in small scale climate change can be seen at the urban level, wherein broader environmental changes are being felt in greater mold (Grimmond 83). Urban climates have changed. Among the effects of urbanization on climate are the revise of energy and water exchanges and airflow delinquent to surface and atmospheric changes and urban warming collect to direct anthropogenic emissions of heat, pollutants and carbon dioxide (Grimmond 83).\r\nWhile there are some cities that can be considered lucky, because their large spaces of irrigated greenspace comport cooler temperature, a majority of the cities puzzle up to a 10-degree-Celsius difference in temperature (Grimmond 83).\r\nThe materials chosen and used in the bend of buildings and other infrastructure in urba n locations and other factors such as the distances between such structures all contribute to urban warming (Grimmond 86). The morphology of cities, particularly in terms of the width, height and density of the buildings therein, take solar access in solar day and the cooling rates at shadow (Grimmond 83). Unfortunately, urban warming has grave implications to inhabitants, such as those relating to their well-being, health and comfort (Grimmond 86). Compared to inelegant environments, urban locations are warmer by an average of 1 to 3 degrees Celsius (Grimmond 83).\r\n star of the scariest implications of urban warming is felt generally by the poor (Grimmond 87). For example, heat waves move all over India in 1998 and caused injuries and deaths (Grimmond 87). The similar catastrophe occurred in France and Spain in 2003 (Grimmond 87).\r\nWith affect to the effect of urban warming on human comfort, there is involved a vicious cycle. The intense heat makes masses uncomfortable . Thus, they would want to use airconditioning systems (Grimmond 87). The increase use of airconditioning, on the other hand, generates more heat and demands more energy with increase generation of electricity, which again would cause increase urban warming (Grimmond 87).\r\nIndeed, this is not an inordinate fear. The change magnitude use of airconditioning had already been observed in large continents such as Asia, Europe and North America (Grimmond 87). Such change magnitude demand has been observed to cause amplified electricity generation (Grimmond 87). This, in turn, results in the production of more greenhouse gases in the atmosphere, which again stars to intensified global warming (Grimmond 87). With the continued abuse by people of the environment and the continued generation of heat, risks greater than the heat waves get wordd in many countries are very comparablely to come near (Grimmond 87).\r\nIt may be considered that the contribution of urban development and urb an warming to the global scenario is small; however, the dangers tat urban warming poses should not be ignored (Grimmond 87). Gases from urban areas, such as pollution and greenhouse gas emissions are the precedeing anthropogenic sources of global warming (Grimmond 87). Moreover, as discussed above, the experience of warmer climate in the cities lead to increased uptake of energy, which again causes global warming (Grimmond 87). The combinations of many factors, including those occurring in urban zones, would surely give rise to global consequences and implications (Grimmond 87).\r\nIt is important, in any effort to persuade people into action, to make them understand the implications at stake (Grimmond 87). The strategies towards solving the problem of global warming cover a wide range, and any move should involve the partnership of all stakeholders (Grimmond 87).\r\nFor example, in the community level, each person can do his small but significant part in mitigating global warm ing, by avoiding or minimizing the use of airconditioning in order to reduce consumption of energy. Reduced demand for airconditioning would lead to rock-bottom demand in energy supply, which would lead to less(prenominal) production of greenhouse gases (Grimmond 87). Thus, a simple act of minimizing the comforts of the modern world could do wonders in preventing further global warming.\r\nThe threat of continued and prolong global should be enough to stand up concerns among all people, because of the extreme events that we should be disposed(p) for as a consequence of global warming (King 780). For one, global warming causes more water vapor to remain in the atmosphere, which is exactly what the greenhouse effect content (King 780). Increased water vapor is a result of increases in the level of carbon dioxide in the air, and comes on board the increase of temperature in the seas and the earth (King 780).\r\nDe timberlandation is another cast out effect of global warming (King 780; Saxe, et al.). The increased temperature leads to decreased rainfall, which leads to dryer conditions and more forest fires (King 780; Saxe, et al.). Increased global heat contributes to easier detective work up of large fires in the forest. In turn, deforestation again increases global warming, like a vicious cycle. Deforestation deprives the planet of vital carbon sinks, which are necessitate to balance the global carbon calculate (Saxe, et al. 389). Fortunately, this can be reversed through the planting of more trees and building more density in the forests, in order to counter the production and existence of carbon in the atmosphere (Saxe, et al. 389-390).\r\nGlobal warming can also cause the loss of the Greenland ice sheet (King 780). This would cause in force(p) problems because it could raise the sea level round the globe by approximately 7 meters over a period of about a thousand years (King 780). It could also cause enhanced retreat of glaciers in some places (Ki ng 780). Further effects of global warming can also be observed in the oceans, through increased acidity (King 780). The increase in carbon dioxide levels in the atmosphere cause a corresponding increase of the same in oceans, thereby increasing their acidity (King 780). Thus, there are already observed effects on coral reefs and plankton population, while wider opposition on marine life and on the food chain is yet to be observed (King 780).\r\nTo date, a documented summate of 17 coral reef ecosystems have been found to be degraded around the world. This is a huge blow to the planet, since it is estimated that â€Å"coral reefs provide support to ecosystems worth more than $375 billion per annum to the global economy (King 780).” These repellent consequences should be enough to make everyone concerned about global warming and its pestiferous effects on all aspects of life in the planet (King 780). People should be concerned about destroying life and support systems in d ifferent ecosystems, which would eventually affect human lives.\r\nHaving seen the scary possibilities that come alongside global warming, everyone should join the movement towards making this planet greener and healthier. People should be go by stories of forest fires, destruction of ecosystems, and deaths due to heat waves, that are occurring all over the world (King 780; Saxe, et al. 389). The planet is becoming less safe with each passing day that people live in ignorance of the stultification they are causing the environment. Continuous impassivity and inaction could lead to more blasting deaths and further destruction of the planet, which possibilities should raise alarm and concern in all mankind.\r\n for each one person can definitely do his share in minimizing the anthropogenic causes of global warming. We have seen how a simple act of minimizing the consumption of airconditioning could have positive effects on the environment. It is time that each of us does our share t o save our home. This is the only way that future generations could still enjoy earth as we know it.\r\nWorks Cited\r\nGrimmond, Sue. â€Å" urbanization and global environmental change: topical anesthetic effects of urban warming.” Cities and Global environmental Change: 83-88.\r\nHansen, J., Ruedy, R., Sato, M., and K. Lo. â€Å"Global Warming Continues.”\r\nScience, New Series 295 (2002):275.\r\nKellomaki, Seppo, Rouvinen, Ismo, Peltola, Heli, Strandman, Harri and Rainer Steinbrecher. â€Å"Impact of global warming on the tree species composition of circumboreal forests in Finland and effects on emissions of isoprenoids. Global Change Biology 7 (2001): 531-544.\r\nKing, David. â€Å" humour change: the science and the policy.” Journal of apply Ecology 42 (2005): 779-783.\r\nSaxe, Henrik, Cannell, Melvin G. R., Johnsen, Oystein, Ryan, Michael G., Vourlitis, George. â€Å"Tree and forest functioning in response to global warming.” New Phytologist 149 (2001): 369-400.\r\n'

'Bartleby the Scrivener Essay\r'

'In the course of the story the teller describes the each characters however such is particular only to their per stoolance in the body of work and none was revealed in their personal life. The vote counter who is a lawyer in seawall Street keeps a company of iii people, Turkey, Nippers, and Bartleby. Turkey, and English man who has a alien temperament that that the narrators likened to a sun move up in the morning r curioering a equanimity atmosphere and becomes rather overly hot in midday that lasts until dinner.\r\nNippers on the other hand is the antithesis of Turkey. He is plaguy in the morning and is rather calm in the afternoon. Aside from this, he likewise â€Å"dresses like a gentleman” as the narrator would put it in business to Turkey whose fashion statement is anything notwithstanding appealing to the author (Melville, 1935). The narrator says he keeps Turkey and Nippers in his office because they in effect(p) patronage their mood swing.\r\nPerhaps th ey evoke be likened to the typical office clerks who got federal official up with the monotony of their jobs that they have real outburst as ways of coping. zero point is revealed of their personal life notwithstanding since they argon described as efficient by the author, then there is the assumption that despite their mood swings and peculiar outbursts they are likable. On the case of Bartleby, on which the story’s title is attributed, the narrator finds him rather odd.\r\nHe is a copyist same as Nippers and Turkey however he refuses to do other things such as edition a file or send mail. As the story ends it is revealed that he whole kit for the pulseless Letter Office and as the author puts it, Bartleby is â€Å"prone to a crazy hopelessness” and his work in the Dead Letter Office only elegant his depression (Melville, 1935). Bartleby exhibits passive resistance which is attached to his detachment from society and his roles.\r\nIt can be interpreted as hi s refusal to be a slave to the corporate world by doing what he wishes. Overall, he poses no scourge to his Boss since he can elect to dispose him whichever way he pleases but his Boss exhibits a remarkable form of charity and ruth towards him. He purge offers his house for Bartleby to stay at. At the end of the story when he heard rumors of Bartleby’s previous occupation he took pity on him and how his job has destroyed him.\r\n'

'Challenges of the U.S. Healthcare System Essay\r'

' judgement the U.S. Health cautiousness formation brush off be very thought-provoking payable to the organisation is constantly changing from unexampled engineering science; monitor c ar, wellness c atomic number 18 reforms, develop macrocosms and other economic factors that choose a significant impact in the puzzle kayoeding entrustd. This paper go by focus on the stakeholders conglomerate in health c atomic number 18 today. Who be these stakeholders? What atomic number 18 their intentions in the health get by industries? Understanding the everyday, payers, providers, and the suppliers may explain wherefore the health care corpse continues to be take exception.\r\n like a shot U.S. Health maintenance remains is face umteen challenges. concord to Sultz & adenine; four-year-old (2011), this because the growing concern that the Health grapple is a large and thorny to manage and that consume oer 17% of the U.S. crude domestic product and exceeds $ 1.5 trillion in be (p.1). Who are these major stakeholders that sometimes share and often cause unconnected concerns, interest and influence the major region on the health care arrangement? They are the in the public eye(predicate), payers, providers, and the suppliers. The public is the major consumers of the attend provided by the health formation. The insured and the uninsured are both major contri saveors. The public is truly non aware(predicate) of the original cost of healthcare services because of the triplet party payers or the regime’s Medicare/ Medicaid program. The insured is only concern is the cadence of deductible and co-pay due. The uninsured relies on the presidential bound aid and with the lack of understanding cull ER visit instead of autochthonic doctor visit. The public also assumes that healthcare is estimable like other inherits objurgate ( much(prenominal) as protection from the police, fire subdivision or public education) and s hould be approachable to all U.S. citizens. Currently, the number of uninsured is rising, and that’s why low-priced Care deed was employ by chairwoman Obama.\r\nThe challenge is â€Å"How m any uninsured forget genuinely gain reports, and whether the reform equity depart keep healthcare spending ontogeny down are the two many uncertainties in the year ahead?” (Meyer & Evans, 2014, p.15). The consumers also redeem an organization that lobbies command and protection for the public. Such organizations are the American Association of Retired Person, labor organization and a disease specific separate (ACS-American pubic louse Society, The American Heart Association). Traditionally, patient’s behavior is very dependent upon the provider ( physician), and the possibility of excessive services much(prenominal) as diagnostic testing can be done. Currently, lucre has empowers people to strain health information. cyberspace plays a larger role in th eir diagnosis and overlayment. A survey done by pew Re reckon circle round’s meshing & American Life declare oneself (2013), 1 in 3 American adults have gone online to move into out a aesculapian condition, and 35 % of U.S. adults posit that, at one time, or another, they have gone online specifically to try to figure out what medical condition they or someone else might have (p.1). Internet use is becoming to a greater extent normal due to easy main course to the internet with smartphones. There are reliable and not reliable website that patients’ quests to be aware when searching the interment. According to Sultz & unsalted (2011), internet users are becoming more(prenominal) educated and participatory in clinical decision-making (p.59).\r\nThese notwithstanding challenge the doctors on how to speak with a more knowledgeable and involved patients. I see more and more patient dictating their treatment options versus before just doing what the doc tor says. The payers in the U.S. health governing body are very influential group of stakeholders because they are the one paying for the laid-back percentage of the cost. The payers are the public empyrean which includes the federal organization, state and topical anesthetic government. The secluded sectors are the private insurers and telephone line. According to the term Understanding the U.S. Healthcare System (2010), 47% of the expenditures comes from the public sources and 53% from private sources (p.4). They are also the one the currently victorious an active role in determine what those costs should be. The government is considered a dominant allele stakeholder since the implementation of Medicare and Medicaid. The government is the taxing sanction that generates the funds to support the healthcare system. The government’s role is not just a payor but also as regulators and providers through public hospitals, state and local health department and other gover nment facilities. Many regulators were formed over the days to control over various areas in the healthcare system. Most common regulators are the HHS- U.S. Department of Health and Human Services, CMS- the Center of Medicare and Medicaid, and the FDA- the Food and Drug Administration.\r\nThese organizations are created to produce sure everyone is compliant with the current law of U.S. The current healthcare situation has created a significant dilemma in our country. Problems such as the rising uninsured, the advancement of engineering and the rising cost and healthcare system emphasis on cure and cuckold prevention are just some of the example of why the president implemented the Affordable Care constitute (ACA). The Affordable Care Act ordain help millions of Americans who currently lack insurance, working-aged men and women and their children, access to Medicaid. It will help small business and individuals with modest means purchase reasonably priced plans. Shaw et al. (20 14) mentioned by 2019, the law will take in health coverage and the health benefits of insurance-to an estimated 25 million more Americans (p. 75). It has already muted discriminatory insurance practices, made coverage more affordable, and realized new provide to curb costs (including tests of new health-care spoken language models) (Shaw et al., 2014). The ACA has positive and negative points, but our lush healthcare system needs to bug out in these issues and challenges in tack to mend our healthcare system.\r\nThe providers in the U.S. Healthcare System include all individuals and organization that provide healthcare services to the consumers. Individuals include; physicians, concord practitioners, nurses, dentist and any allied health providers. Organization include; hospitals, nursing homes, community-based ambulant services and other similar entities. Although health professional is the one that provides actual care, hospitals in particular offer the environment in wh ich care can be provided and are compensated by the payers for the service provided. As an employee in the healthcare, I have seen a physician that provides extra service or chargeable item in order to adjoin revenue. This assumption is hard to rebel because of documentation provided by a physician and conflicting opinions. Physicians and organization that emphasis on cure can fail to intimation prevention. Healthcare professional can tip and influence public opinion specially when it comes to health. According to Sultz & Young (2011), headmaster Association has considerable influence over legislation proposals, regulation, musical note issues, and other insurance-making matters (p.16). A good example is the lobbying dominance of the American checkup Association plays an beta role.\r\nIt also includes the American Hospital Association, and The American Nurses Associations are just a fewer of the powerful organization that has a role in the health policy decisions. o ther outstanding issue is the long term care in the aging population is also creating challenges in our healthcare system. The increase of senior citizen (baby boomers) will create higher(prenominal) cost deficit and it’s important to create a seamless process of care to avoid duplication of services. Currently, healthcare providers are experiencing budget constraints and strict regulation. Providers are asked to have EMR (electronic medical record) system implemented. According to CMS.gov, as required by law, President Obama issued a sequestration order on March 1, 2013. Under these mandatory reductions, Medicare EHR inducing payments made to eligible professionals and eligible hospitals will be reduced by 2%. This 2% reduction has been applied to any Medicare EHR incentive payment for a reporting period that ended on or after April 1, 2013 (â€Å"EHR incentive programs,” 2014).\r\nContinuous quality cleansement (CQI) should be included in gathering data quality in the organization, since it focuses on processes rather than the individual; reorganise both external and internal customers, and promotes the need for objective data to analyze and improve processes (Green & Bowie, 2011, p. 258). A more patient-centered care and prevention could cause impact on how the providers handle business. The suppliers in the healthcare system include medical equipment companies and drug companies. These suppliers have grown immensely due to the search of greater efficiency in the spoken language of health care services. These companies are for network and strive for competition in the foodstuff just like the insurance companies. newfangled drugs, technology and new creative functional procedures have made it possible to treat diseases that have a bad prognosis. reinvigorated technologies have created a behavior enhancing and life-extending medical accomplishment (Sultz & Young, 2011, p.44). Strategies have win over in the delivery of care due to the advancement of technology and brought new problems.\r\n revolutionary medical and technological advancement came with new financial and ethical dilemmas. Financial saying is whatever it’s beneficial or not the use of new technology has contributed to the higher healthcare cost. The ethical dilemmas are greater ability to prolong the life can likely cause suffering quality of life and the right to die. The AMA (American Medical Association) and the federal government have real programs to examine these issues and provide information to the public and to the providers. In the Technology Assessment Act of 1972, â€Å"it is essential that, to the fullest extent possible, the consequences of the technological applications be anticipated, understood, in the determination of public policy on existing and emerging interior(a) problems” (Shultz & Young, 2011,p.45). The Agency of Health Care Policy and Quality has a challenging mission to adhere and sort out t he complicated health care system and determine what is reasonable to whom, when and at what cost.\r\nIn conclusion, the U.S. Health Care system is changing economically and socially. Healthcare organizations are challenge in providing high quality, affordable care, and healthcare services are an increasingly difficult challenge. The reported outcomes are critical components of evaluating whether clinicians are improving the health of the patient, safety, reducing cost and encouraging preventive care. Containing the cost will affect the quality of care; that will raise the question to quality and access. In addition, there are strong pressures on providers to examine and document the outcomes and effectiveness of their health care actions. All stakeholders must substitute in order to resolve the decomposable issues such as treatment options, electron orbit of laws, politics, journalism, administration, public and providers. There are slake a lot of issues that need improvements, but I believe that our government and lodge will find a centre of attention ground to solve these issues.\r\n'

'Loss and Grief\r'

'What is personnel casualty? What is melancholy? pass is most practically equated to end only generally, â€Å"loss occurs when an event is perceived to be negative by privates involved, and it results in long-term changes in match slights friendly situations, kinds, or way of viewing the world and wizard and precisely(a)self” (Marriage and Family Encyclopedia 2008). unmatchable slopes to bed loss in sensation’s lifetime. Children ordinarily experience loss through a finis of a pet or a p arnt. Adults likewise experience loss through dying of a spouse or because of divorce; they may also experience job or health losses.When we value some thing or someone that we befogged, we experience wo. â€Å" trouble is the psyche’s natural healing chemical reaction when faced with change and loss” (PsychCentral 2008). This suggests that heart a manpowerd is a normal and natural experience to a mortal who has experienced somebodyal loss. Fur ther much, it is said to be a â€Å"process, not an event” (PsychCentral 2008) which operator that wo should be willed and given time to comp permitely take beam. Strayhorn enumerates the characteristics of rue (PsychCentral 2008). First, he says that pain is a natural startle of suffer.One may choose to repress or abridge the pain but he says that shape up losses in life tidy sum always generalisation it and eventually, the hurt only doubles. Second, he maintains that ‘grieving is a highly individualised process’ (PsychCentral 2008). This demonstrates how different from individually one somebody is dapple in sorrowfulness. Though mourning is said to be a universal and a natural occurrence, the way one individual bewails differs from another. Furthermore, be aw be of the quintuplet stages of regret: â€Å"shock, anger, bargaining, depression, studyance” (PsychCentral 2008) fosters one to cope with heartbreak.Lastly, Strayhom state s that â€Å" grief has no timetable” (PsychCentral 2008). mourning wherefore should be allowed to take its own course. However, each individual in the process of grieving should also do activi crossties to help them heal. Constantly sharing ones deepest senti workforcets to a certain(p) friend is always beneficial to a person in grief. on that point have been k todayn grief responses, â€Å" such(prenominal)(prenominal) as a yearning for the doomed person or state of affairs, a gather up to think repeatedly about past events, a comprehend of guilt, or even thoughts of suicide.(Death cite 2008)” correspond to the Death name and address website (2008), Terry Martin and Kenneth Doka formulated 3 basic somas of grief. First is the Intuitive Pattern, where the mourner freely kindifests his/her feelings. He/She erect display intense emotions such as outbursts and exacting. Any ungenerouss to allow the griever to vent out his/her emotions is beneficial for l intel. Second is the imple custodytal Pattern where the griever would recall memories of the dead person and doing something in relation to those thoughts.An ex axerophtholle cited by Martin and Doka (1999) where a man who has alienated his daughter in a vehicular accident fixed the fence which his daughter has ruined during the accident. He said that it was the only thing he could repair. Third is the Dissonant Pattern. â€Å"Dissonant grievers are those who experience grief in one pattern but who are inhibited from finding harmonious ways to express or ad gifted to grief that are compatible with their experience” (Death Reference 2008). For instance, when a man retires his wife, he can feel the gibe to cry with his daughters and to register weakness.However, he chooses to keep it, as it is inappropriate for a man to do so. Wo men who lose spouses can experience the same situation, when she inhibits emotions and puts up a strong stance to protect her children. Loss and Grief on Different Perspectives There have been respective(a) studies about grief and prove that its characteristics are individualized and unique. On the one hand, children, grieve differently from adults (PsychCentral 2008). immature kids often think that the person who died will soon come back as seen in vignette shows.Meanwhile, there are signs which tell whether the child is experiencing real grief. He/She tends to make out immature for his/her age and there is also a considerable decrease in school performance. When these are present, Cohen advises the child be seen by a child psychologist (PsychCentral 2008). On the other hand, men and women also have distinct characteristics of grief. In an denomination written by Karen Carney in PsychCentral (2008), she enumerates the key points on how men grieve basing from Tom Golden’s book entitled ‘Swallowed by a serpent: The Gift of the Masculine Side of Healing’ (1997).Golden mentions that counselors tend to use approaches similar to what they use towards women, which was later on found to be ineffective to men. Men ordinarily cope by busying themselves with any act that would all use the mind or the body (PsychCentral 2008). Moreover, men try to go on living their lives as normal as possible like passing play on their usual routine. In contrast, women are prone to their feelings. They have the tendency to recall memories of the loved one who died (Linda-Angel 2005).It is significant to note that there are differences amongst the characteristics of the male and female human brain, which can be a cause of the distinction on how each sex grieves (PsychCentral 2008). In a study by Buchebner-Ferstl (2002), she mentions the differences between how a woman and a man deal with loss of a loved one (death). She said that women have broader social networks than men, and that women are often the source of social support between the couple. creation the case, she says that some exper ts would conclude that because of this, women cope better with loss.Moreover, â€Å"women are said to have a more emotionally-oriented behaviour, and men are said to be more problem-oriented” (Buchebner-Ferstl 2002). This means that women are more geared than men to grieve and share their emotions with other people. In addition to this, she mentions that question shows that women are said to have a â€Å"stronger sense of survivability … [and] men are biologically more supersensitized to the negative effects of stressors” (Buchebner-Ferstl 2002). This demonstrates that women are more apt to survive loss than men.Also, it was mentioned in the Death Reference website (2007) that men were socially conditioned to hide their emotions. In contrast, women can openly share their feelings to other people, allowing grief to take its course. Further, Louis LeGrand states that the grammatical gender difference â€Å"does not mean that men are not grieving; it does orient that they may not accomplish the task as successfully as women” (LeGrand 1986:31). In a look conducted by Martin and Doka (1999), the differences between how women and men grieve were tackled. Their inquiry showed the following:• Upon the death of a spouse, the widower would usually engage in activities such as works or gym activities and are likely to restore to alcohol. Conversely, widows spend time with friends and family for emotional support. • Similarly, for those parents who have woolly-headed a child, the mothers tend to show emotions than the father. • For those middle-aged children who lost a parent, the sons were more likely to engage in busy activities to deal with the loss while daughters show grief. • Basing on the older generation, there are only slight differences on manifesting grief.• â€Å"Differences in gender are also affected by other variables such as social class, generational differences, and cultural differencesâ₠¬Â (Death Reference 2008). • The paper suggests that studies show varying results in term of which gender copes with grief more effectively. The study of grief on the basis of gender is remarkable just Doka claims that the â€Å"[grief] pattern is not determined by gender” (Death Reference 2008) alone but is affected by other factors as well. Cultures differ in social norms and practices.There are societies where the sight of a man crying in grief is as acceptable as when a woman does (Death Reference 2008). Additionally, cultures differ in valuing relationships and adjunct towards people and things, thus they also differ in grief experiences. warnings of Loss and Grief There have been a number of loss and grief models that is base on the notion that every person in grief goes more or less in ‘the same sequence of stages in the retrieval from grief, and at relatively the same speed’(Slap-Shelton 2008). especially on death, Kubler-Ross has formulated a model comprise of 5 stages, as follows:1. ‘Denial and Isolation’ †The person who experienced death cannot accept that he/she actually lost a loved one. In abominable cases, the person completely denies that death took place (Slap-Shelton 2008). 2. ‘ evoke’- Here the person expresses anger towards others, and towards God, questioning Him why the loss had to happen to him/her (Slap-Shelton 2008). 3. ‘Bargaining’ †This is when one bargains and tries to agree with God. 4. ‘Depression’ †As the person realizes and ack promptlyledges the loss, he/she now experiences depression and deep badness.5. ‘Acceptance’- The bereaved now accepts the reality of loss and is able to project a new life ahead. Based on a number of literatures on grief, Kubler-Ross’s model has become one of the most known and familiar. This model appears to specialize the stages of dying, phases of grief and is applicable not only to death but in other losses such as divorce or a break up. In the University of Kentucky website, Kastenbaum criticizes Kubler-Ross’s model, saying that these are not supposed to be stages as they do not happen chronologically (1998).In addition, he says that all these five stages are not necessarily undergone by a person dying or grieving. He skinther maintains that grief is unique to every individual (University of Kentucky 1998). This demonstrates that these stages rig the process of grieving which is supposed to be individualized. next this, various theoretical models on loss and grief were formulated. Charles Corr, specifically believed in the individuality of coping with death (University of Kentucky 1998). People differ in values and then they also differ in need and coping mechanism for the same experience of loss.Meanwhile, Worden, Leick &type A; Davidsen-Nielson (1991) proposed quadruple means to understand loss and help accept its reality. First, one should recognize the fact that someone died or left for good. Second, one should not suppress the emotions but let them take their course. According to Slap-Shelton, (1998) among the intense emotions that one can feel during loss include â€Å"sadness, despair, anger, guilt, fear, loneliness, shame, jealousy. ” Furthermore, to allow feeling these and letting these manifest will help in recovering over the loss.Third, it is advisable to let in something new in your life. For instance, one can learn a new skill or find a new set of friends. done the process the person who experienced loss can grow despite the circumstance. Lastly, one ought to â€Å"reinvest emotional push button into the present” (Slap-Shelton 1998). This means that the bereaved person should contract on what is ahead and what he/she can do to live this new life without the person who died. Some, for example, do activities that commemorate and celebrate the goodness of the dead person.Furthermore, grief can be more understood in two other perspectives: psychoanalytic and attachment perspectives Basing from psychoanalysis, grief stems out of the griever’s uncertainty of where his/her relationship stands, now that the partner died. At the same time, â€Å"the psychological bring of grief is to free the individual of the tie to the deceased and allow him or her to achieve a gradual detachment by means of a process of grief work” (Death Reference 2008). some(prenominal) counselors and therapists have been influenced by this however such conjecture has also been criticized.On the other hand, Bowlby’s scheme was based on the biological aspects of grieving. He maintains â€Å"that the biological function of grief was to regain proximity to the attachment figure, time interval from which had caused anxiety” (Death Reference 2008). This means that when humanness are separated from a figure whom or which they had attachment to, this results to reactions of grie f. Conclusion According to the Marriage and Family Encyclopedia (2008), more recent models on loss and grief are now focused on â€Å"identifying symptoms [rather than] the process of grieving” (Marriage and Family Encyclopedia 2008).Stroebe and Schut (1990) formulated the Dual Process pretense of head. Humans cope with grief with a confederacy of both â€Å"loss druthers” and â€Å"restoration orientation”. Loss orientation is allowing grief to take place for instance crying and reaching out to others while restoration orientation is â€Å"adjusting to the many changes triggered by loss” by engaging in new activities. much(prenominal) dual model recognizes grief as a â€Å"dynamic and fluctuating process, labeled ‘oscillation,’ that incorporates confrontation and scheme of different components at different times, and includes both positive degree and negative reappraisals” (Death Reference 2008).For instance, a man who lost his wife learns how to paint and takes pleasure in the activity (restoration orientation). However in the process, he is asked to paint a memorable place and thus reminded of the wife who has died and feels sad about it (loss orientation). Basing from the literature reviewed, grief can be described as universal since all humans at one point in their lives experience grief. Grief is natural since it is said to be an needed response to loss. However, there has not been an encompassing theory that can gauge grief; perhaps out-of-pocket to its vastness and complexity.Further studies and research, particularly on the biological perspective, how grief starts and where it ends, will allow a deeper understanding of human grief. List of References Buchebner-Ferstl, S 2002, Gender-specific differences in coping with bereavement, Osterreichisches Institut fur Familienforschung, Austria, viewed 30 Maarch 2008, <http://209. 85. 175. 104/search? q=cache:RPECPjjHDU8J:www. oif. ac. at/aktuell/buch ebner-ferstl_en. pdf+men+women+grief+psychology&hl=tl&ct=clnk&cd=25&gl=ph>. Carney, K 2006, How men grieve, 4 November, viewed 1 April 2008, <http://psychcentral.com/lib/2006/how-men-grieve/>. Cohen, H 2007, Children and grief, 4 June, viewed 1 April 2008 <http://psychcentral. com/lib/2007/children-and-grief-2/> Coping With Loss 2008. Marriage and Family Encyclopedia viewed 28 bump into 2008 <http://family. jrank. org/pages/750/Grief-Loss- ruin-Coping-with-Loss. hypertext mark-up language>. Encyclopedia of Death and Dying. 2008. [online]. [accessed 29-31 March 2008]. lendable from World Wide Web: <http://www. deathreference. com/>. LeGrand, L. 1986 Coping with time interval and loss as a young adult. Springfield, IL: Charles C.Thomas. Martin, T. & Doka, J. 1999. Men dont cry, women do: Transcending gender stereotypes of grief. Philadelphia: Taylor & Francis. Rosenblatt, P. , Walsh, R. & Jackson, D. 1976. Grief and mourning i n cross-cultural perspective. Washington, DC: HRAF Press. Schwab, R n. d. ,Gender, Encyclopedia of Death and Dying, viewed 29 March 2008, <http://www. deathreference. com/Gi-Ho/Grief. hypertext mark-up language>. Slap-Shelton, S 1991, The phases and tasks of grief work, egotism Help Magazine, viewed 31 March 2008, <http://www. selfhelpmagazine. com/articles/loss/phases. html>.Strayhorn, D 2008, Surviving a life crisis, 21 January, Psych Central, viewed 1 April 2008,<http://psychcentral. com/lib/2008/surviving-a-life-crisis/>. Stroebe, M. , & Schut, H. , 1990. The Dual Process Model of Coping with Bereavement: Rationale and Description. Death Studies 23, p. 197â€224. Stroebe, M, Stroebe, W & Schut, H, Theories on grief, viewed 29 March 2008, <http://www. deathreference. com/Gi-Ho/Grief. html>. Women, men & grief 2005, Child Bereavement Trust, viewed 31 M arch 2008, <www. linda-angel. com/articles/Women, Men & Grief. pdf †28k 2005&g t;.\r\n'

'Views On Living In Orphanage Health And Social Care Essay\r'

'Methodology of query organizes entirely the constituents of the survey in a appearance that is ab proscribed likely to take valid replies to the hired gun jobs that hand over been posed ( destroy and Grove, 2002 ) .It refers to assorted consistent stairss that atomic number 18 by and large adopted by the look for doer in analyzing the explore job.\r\nThis chapter presents the research design, puting, population, sampling size and try technique, seek standards, woodpeckers apply, expression of the tools, cogency, dependability, pilot survey and informations accumulation adopted for the survey.RESEARCH APPROACHThe research attack is an over every program chosen to assault taboo the survey. The choice of research attack is the staple fiber process for the behavior of research enquiry. For the present survey, a descriptive comparative study attack was considered most appropriate as the intent of the survey was to gather an apprehension of the social welfare with kids ‘s invests on vitality in orphans asylum and to comp ar the well-being and send ‘s on career in orphans asylum of both maternal and orphaned kidsSetting OF THE STUDYâ€Å" Puting ” refers to the acres where the survey is conducted.\r\nTwo orphanages home were selected for the survey. One orphanhood place is at Thondamuthoor which of consists of merely fe antheral kids who are remaining in domentry. The fleshly installations in that make-up are with dining hall, kitchen, little bid im recrudesce and church to worship. There are two wellness professionals to look after those kids. They are holding tution, waste clock time and appeal clip. Every twelvemonth supplication cantonment is conducted on the month of May.\r\nAnother orphanhood is at Podanur which consists of both male and female kids who are remaining in separate. The physical installations like drama land library and diversion suites. They celebrate each festivals in the orphanhood.P opulationThe population to a lower place the survey was the kids from 8 years to 16 years remaining in orphanhood place.SAMPLE SIZESample refers to a subset of population that is selected to take part in a peculiar survey ( Burns and Grove 2002 ) . In this survey sample size consisted of 160 ; Out of 160 sample 80 sample was selected for parental group in which kids with parents and 80 sample was selected for orphaned group in which kids without parents. In Thoondamuthoor orphan mature the sample selected were 100 in that 30 parental and 30 parentless kids and in Podanur orphanage the sample selected were 100 of which 60 were female 30 were comes under parental and 30 comes under motherless kids and of 40 males 20 was parental and 20 was fatherless kids.Sampling TechniqueThe sample was selected by impartial random trying technique under chance sampling. In this simple random technique, a lottery method was utilise. A advert of names were written and batch was hustling indivi dually for parental and unparented kids. Then the samples were selected indiscriminately.Sampling StandardsInclusion standards\r\n squirt of both the sex\r\nChilds who are the occupants of orphanhood\r\nChildren with age between 8-16 old ages.\r\nExclusion standards\r\nChild with mentally retardedDescription OF THE TOOLThe tool used in this survey was an consultation schedule and ego administered questionnaires. The interview agendum is used to mensurate the demographic informations and positions on feel in orphanhood. The ego administered questionnaires were used to cadency the well-being of the kids which consists of quaternion dimensions such as psychological, educational, social and future.PART †IPart †I was intentional to give up demographic informations of the parental and unparented kids. Demographic information for parental kids ( age, sex, instruction of kids, devout continuation of stay in orphanhood, kinfolk members in place, business organisation o f male parent and female parent, monthly income of male parent and female parent, visit by household members and how oftentimes visit by household members travelling place and how frequently traveling place, traveling out with parents and how frequently go out with parents )\r\nDemographic informations for parentless kids ( age, sex, instruction of kids, protraction of stay in orphanhood, have any relations, visit by relations and how frequently visit by relations, traveling to relatives topographic forefront, anybody fetching out and how frequently taking out ) .PART †TwoThis deal out was designed to measure the positions on life in orphanhood. It is a common chord bakshish calibrated shelve which has assorted facets including physical, mental, societal, frantic, and religious. In this three consign graduate table each facets consists of 4-8 points used to rate the responses in three grades of Highly satisfied †3, Satisfied †2, and non satisfied †1 . And a separate five point have table to measure the public position of life in orphanhood. It consists of merely mavin point was used to rate the responses under the class of sincerely happy †5, happy †4, ca nt state †3, lovesick †2, really and unhappy †1.PART †ThreeThis portion was designed to measure benefit. It is a ego administered questionnaires for welfare which has cardinal dimensions including psychological, educational, societal and future.\r\nIn this scale each dimension consists 5 †9 inquiries used to rate the responses.\r\nMost of the clip †3\r\nSome of the clip †2\r\nnone of the clip -1Marking AND INTERPRETATION OF MarkingWellbeing Assessment Scale:\r\nIt consists of four dimensions such as psychological, educational, societal and future. The negative points are scored reversely.S.NoDimensionMarking AND ScalingLow WellbeingAverage WellbeingHigh Wellbeing1.\r\nPsychological\r\n1 †9\r\n10 †18\r\n19 †27\ r\n2.\r\nEducation\r\n1 †9\r\n10 †18\r\n19 †27\r\n3.\r\n accessible\r\n1 †6\r\n7 †12\r\n13 †18\r\n4.\r\nFuture\r\n1 †5\r\n6 †10\r\n11 †15\r\n5.\r\nOverall\r\n1 †29\r\n30 †58\r\n59 †87Positions ON Life IN ORPHANAGE TOOLThe tool consists of three point graduated table and five point graduated table. In three point graduated table it consists of five factors such as physical, mental, societal, emotional and religious.S.NoPositionsHIGHLY SATISFIEDSATISFIEDNOT SATISFIED1.\r\nPhysical choose\r\n15 †21\r\n8 †14\r\n1 †7\r\n2.\r\nMental indispensableness\r\n9 †12\r\n5 †8\r\n1 -4\r\n3.\r\nSocial Need\r\n17 †24\r\n9 -16\r\n1 †8\r\n4.\r\nEmotional Need\r\n15 -21\r\n8 -14\r\n1 †7\r\n5.\r\nReligious Need\r\n9 †12\r\n5 †8\r\n1 †4\r\nGeneral feeling of life in orphanhood\r\nFive Point ScaleScaling MarkVery Happy 5\r\nHappy 4\r\nCa nt Say 3\r\nUnhappy 2\r\nVery Unhappy 1DEVELOPMENT OF THE TOOLThe victimisation of the tool took three months of strenuous attempt for the undermentioned activities. The tool was developed based on the aims of the survey, critical review of literature sing parenting, growing and development and well-being of kids and with the expert ‘s cognitionVALIDITY OF THE RESEARCH TOOLThe research tool including the aim of the survey along with the standards check list were submitted to five experts †four Nursing experts, and Psychologist. The four nursing experts were Professors with Master Degree in Nursing and on the job(p) in different colleges of nursing in Coimbatore with much than 5 old ages of experience. The psychologist is the academic professor, DJ academy for Managerial Excellence.RELIABILITY OF THE RESEARCH TOOLThe dependability of the wellbeing judging graduated table and interview agenda was tried by trial retest method. The trial was administered to 16 kids populating in orphanhood. Correlation co-efficient was calculated by Karl Pearson ‘s method. The obtained ‘r ‘ value was 0.82 for overall wellbeing appraisal graduated table and 0.9 for Interview agenda of positions on life orphanhood, which confirmed that there was high positive correlational statistics and internal consistence of the tool.PILOT STUDYA pilot survey was conducted in an orphanhood at Pottanampudoor in order to install the practicableness and feasibleness of the tool. A formal liberty was obtained from the\r\nAdministrative Officer. 16 samples were selected, 8 samples from parental kids and 8 samples from unparented kids. Samples were selected by utilizing simple random sampling technique. by and by a self debut and good resonance with the kids the research worker collected the informations on positions on life in orphanhood and wellbeing through interview agenda and ego administered questionnaires. The continuance of pilot survey was ten days.The retest was administered after 8 yearss.The continuan ce of roll uping informations takes 20 minitues for one sample on one twenty-four hours. The wellbeing judging graduated table is holding four dimensions which accept psychological, educational, societal, and hereafter. The dependability of each dimension is go over and the overall dependability besides checked. The dependability of the psychological dimension.61, educational dimension.86, societal dimension.89, future dimension.71 and the overall dependability is.88. Positions on life in orphanage interview agenda have five factors which include physical, mental, societal, emotional and religious, and a general feeling. The dependability for each factor is checked and the overall dependability besides checked. The dependability of the physical factor.75, mental factor.72, societal factor.81, emotional factor, religious factor.79 and for general feeling.78 and the overall dependability is.9. Pilot survey be the adequateness of the tools and technique. data COLLECTION PROCEDUREBe fore beginning of informations aggregation one time once more the permission was obtained from the potence through orally. The research worker foremost started the informations aggregation process at thondamuthoor orphanhood and visited the floors where the kids ‘s were remaining, selected 30 samples of parental kids and 30 samples of unparented kids who are all carry throughing the inclusion standards. Then the research worker explained the intent of the survey to the kids and obtains the willingness and engagement in the survey. aft(prenominal) the sample was selected, a brief debut close to ego and survey purpose was given to the kids. After obtaining their resonance and willingness, the informations collected sing the demographic features and for kids ‘s positions on life in orphanhood, interview agenda was used for the well-being of the kids, ego administered questionnaires was used. For both parental and unparented kids the informations are collected individuall y.\r\nAfter roll uping the information from the thondamuthoor orphanhood, the research worker visited another orphanhood which is in Podanur and started the informations aggregation process by choosing 50 parental and 50 parentless kids who are all carry throughing the inclusion standards. The information was collected under the same process. The informations aggregation period was 30 yearss.Plan FOR DATA ANALYSISThe informations obtained were analyzed in footings of the survey utilizing descriptive and inferential statistics.Descriptive statisticsFrequency and per centum distribution were used to analyse demographic variables and to measure and compare the degree of wellbeing and positions on life in orphanhood.\r\nMean and intend score per centum was used to convey the degree of good being and positions on life in orphanhood.Inferential statisticsChi-square was used to happen out the association between the positions on life in orphanhood with selected variables of the kids and t he association between degrees of wellbeing with selected demographic variables of the kids.\r\nUnpaired â€Å" T ” trial was used to find the important difference in the degree of wellbeing with positions on life in orphanhood.\r\n'

'Exercise 7 Respiratory System Mechanics\r'

'EXERCISE 7 respiratory formation chemical mechanism O B J E C T I V E S 1. To inform how the respiratory and circulatory systems fit together to enable gas ex miscellanea among the lungs, product line, and form winds 2. To define cellular respiration, sp realiseing, alveoli, wide of the do s realize, inspiration, termination, and incomp permite(p) derivative pres original 3. To explain the differences in the midst of tidal flashiness, inspiratory arriere pen prove tawdriness, expiratory re wait on lot, life-sustaining competency, eternal rest great deal, total lung capacity, laboured alert capacity, forced expiratory volume, and minute respiratory volume 4.\r\nTo list various factors that contact respiration 5. To explain how surfactant controls in the lungs to promote respiration 6. To explain what clears in pneumothorax 7. To explain how hyperventilation, re eupnoeic, and confidential informationholding affect respiratory volumes T he physiologic functions of respiration and circulation ar essential to life. If problems develop in other physiological systems, we earth-clo decline still survive for some date with step up jiberessing them. But if a persistent problem develops inwardly the respiratory or circulatory systems, death can ensue at bottom minutes.\r\nThe primary role of the respiratory system is to distribute case O to, and remove cytosine dioxide from, the cells of the bole. The respiratory system works hand in hand with the circulatory system to achieve this. The term respiration includes animatedâ€the movement of disseminate in and egress of the lungs, also known as ventilationâ€as well as the bewitch (via short letter) of oxygen and ampere-second dioxide among the lungs and proboscis tissues. The heart pumps deoxygenated livestock to pneumonic capillaries, where gas exchange occurs between blood and alveoli ( transfer sacs in the lungs), oxygenating the blood.\r\nThe heart so pumps th e oxygenated blood to body tissues, where oxygen is used for cell metabolism. At the aforementi aced(prenominal) time, one C dioxide (a waste product of metabolism) from body tissues diffuses into the blood. The deoxygenated blood consequently returns to the heart, completing the circuit. Ventilation is the result of vigour abridgment. The clo currentâ€a domeshaped t revokeon that divides the pectoral and abdominal vigour cavitiesâ€contracts, making the thoracic pit larger. This reduces the insistency at bottom the thoracic pitf both, dispense withing atmospherical gas to take vocalization the lungs (a impact called inspiration).\r\nWhen the diaphragm relaxes, the draw within the thoracic cavity appends, forcing course by of the lungs (a process called spillage). Inspiration is confacered an â€Å" vigorous” process be grounds muscle compressing requires the use of ATP, whereas expiration is usually figureed a â€Å"passive” process. Wh en a someone is running, however, the external intercostal muscles contract and make the thoracic cavity even larger than with diaphragm contraction alone, and expiration is the result of the inner(a) intercostal muscles contracting.\r\nIn this case, both inspiration and expiration atomic number 18 considered â€Å" spry” processes, since muscle contraction is needed for both. Intercostal muscle contraction works in conjunction with diaphragm muscle contraction. 87 88 ferment 7 (a) Atmospheric pressure Parietal pleura Thoracic debate Visceral pleura Pleural cavity Transpulmonary pressure 760 mm Hg 756 mm Hg 4 mm Hg 756 760 Intrapleural pressure 756 mm Hg ( 4 mm Hg) Lung Diaphragm intrapulmonary pressure 760 mm Hg (0 mm Hg) (b) F I G U R E 7 . 1 respiratory volumes. a) initiation covering fire of the respiratory Volumes experiment. (b) Intrapulmonary and intrapleural relationships Respiratory dodge chemical mechanism 89 Respiratory Volumes Ventilation is pulsed as t he frequency of vivacious multiplied by the volume of individual(a)ly(prenominal) breath, called the tidal volume. Ventilation is needed to maintain oxygen in arterial blood and carbon dioxide in venous blood at their figure levelsâ€that is, at their commonplace partial pressures. [The term partial pressure refers to the equilibrium of pressure that a single gas exerts within a mixture.\r\nFor example, in the atmosphere at ocean level, the pressure is 760 mm Hg. Oxygen makes up well-nigh 20% of the total atmosphere and at that placefore has a partial pressure (PO2 ) of 760 mm Hg 20%, close to 160 mm Hg. ] Oxygen diffuses drink down its partial pressure gradient to less(prenominal)en from the alveoli of the lungs into the blood, where the oxygen attaches to hemoglobin (meanwhile, carbon dioxide diffuses from the blood to the alveoli). The oxygenated blood is indeed transported to body tissues, where oxygen again diffuses down its partial pressure gradient to leave the b lood and slip in the tissues.\r\nCarbon dioxide (produced by the metabolic reactions of the tissues) diffuses down its partial pressure gradient to spring from the tissues into the blood for transport back to the lungs. at one time in the lungs, the carbon dioxide follows its partial pressure gradient to leave the blood and enter the contrast in the alveoli for export from the body. Normal tidal volume in humans is almost euchre milliliters. If one were to breathe in a volume of ambiance travel equal to the tidal volume and thus stretch to breathe in as ofttimes aureole as thinkable, that essence of agate line (above and beyond the tidal volume) would equal about 3100 milliliters.\r\nThis join of denudate is called the inspiratory reserve volume. If one were to breathe out as more than business line as possible beyond the radiation diagram tidal volume, that amount of air (above and beyond the tidal volume) would equal about 1200 milliliters. This amount of air is called the expiratory reserve volume. Tidal volume, inspiratory reserve volume, and expiratory reserve volume together constitute the vital capacity, about 4800 milliliters. It is important to cable that the histological structure of the respiratory tree (where air is found in the lungs) bequeath not depart all air to be breathed out of the lungs.\r\nThe air remaining in the lungs after(prenominal) a complete exhalation is called the residual volume, customaryly about 1200 milliliters. Therefore, the total lung capacity (the vital capacity volume plus the residual volume) is approximately 6000 milliliters. All of these volumes (except residual volume) can be considerably measured victimization a spirometer. Basically, a spirometer is composed of an inverted chime in a water tank. A breathing vacuum tube is connected to the bell’s interior. On the exterior of the inverted bell is attached a pen device that records respiratory volumes on radical.\r\nWhen one exhal es into the breathing tube, the bell goes up and down with exhalation. E reallything is sterilise so that respiratory volumes can be read trailly from the publisher record. The paper moves at a pre-set speed past the recording pen so that volumes per unit time can be easily dedicate a bun in the ovend. In totalition to measuring the respiratory volumes introduced so far, the spirometer can also be used to realize pulmonary function visitations. One such(prenominal) test is the forced vital capacity (FVC), or the amount of air that can be put downled completely and as quickly as possible after taking in the deepest possible breath.\r\nAnother test is the forced expiratory volume (FEV1), which is the parcel of vital capacity that is exhaled during a 1-sec period of the FVC test. This survey is generally 75% to 85% of the vital capacity. In the following experiments you pull up stakes be simulating spirometry and measuring apiece of these respiratory volumes using a p air of mechanical lungs. Follow the operating instructions in the Getting origined section at the effort of this lab manual to start up PhysioEx. From the drop-down menu, occupy solve 7: Respiratory System mechanism and jerk GO.\r\nBefore you perform the activities befool the Water-Filled Spirometer characterization to see the experiment performed with a human subject. consequently gibber Respiratory Volumes. You go forth see the start binding for the â€Å"Respiratory Volumes” experiment (Figure 7. 1). At the unexpended(a) is a large vessel (simulating the thoracic cavity) withstanding an air proceed tube. This tube looks like an upside-down â€Å"Y. ” At the ends of the â€Å"Y” atomic number 18 twain spherical containers, simulating the lungs, into which air leave alone give ear. On heyday of the vessel argon controls for adjusting the r of the tube feeding the â€Å"lungs. This tube simulates the windpipe and other air passageways int o the lungs. Beneath the â€Å"lungs” is a smutty platform simulating the diaphragm. The â€Å"diaphragm” leave move down, simulating contraction and increasing the volume of the â€Å"thoracic cavity” to remove air into the â€Å"lungs”; it go forth therefore move up, simulating repose and decreasing the volume of the â€Å"thoracic cavity” to expel air out. At the bottom of the vessel atomic number 18 three waivers: a sidetrack departure, an ERV (expiratory reserve volume) push, and an FVC (forced vital capacity) button.\r\n beating Start go forth start the simulated lungs breathing at approach pattern tidal volume; reticking ERV go away simulate forced exhalation utilizing the contraction of the internal intercostal muscles and abdominal wall muscles; and confabing FVC allow for cause the lungs to expel the most air possible after taking the deepest possible inhalation. At the efflorescence amend is an ambit supervise, whi ch forget graphically parade the respiratory volumes. flavor that the Yaxis displays liters instead of milliliters. The X-axis displays elapsed time, with the space of the full monitor displaying 60 seconds.\r\nBelow the monitor is a series of information displays. A information recording box runs along the bottom length of the covert. put everyplaceing go in info after an entropy-based run provide record your selective information for that run on the quiz. A C T I V I T Y 1 Trial reign Let’s conduct a runnel run to get familiarized with the equipment. 1. snatch up the Start button ( signalize that it immediately turns into a Stop button). squ atomic number 18 moody the touch sensation on the orbit monitor, which currently displays normal tidal volume. Watch the simulated diaphragm cram and fall, and notice the â€Å"lungs” growing larger during inhalation and small during exhalation.\r\nThe escape display on top of the vessel tells you the amo unt of air (in liters) world moved in and out of the lungs with each breath. 2. When the tone reaches the rectify side of the reach monitor, while away the Stop button and then cut through leger get hold ofive information. Your entropy entrust be in the data recording box along the bottom of the screen. This line of data tells you a wealthiness of information about respiratory mechanics. Reading the data from left to right, the setoff data field should be that of the Radius of the air immix tube (5. 00 mm). The following data field, play, displays the total watercourse volume for this experimental run.\r\nT. V. stands for â€Å"Tidal Volume”; E. R. V. for â€Å"Expiratory 90 exploit 7 unobtrusiveness Volume”; I. R. V. for â€Å"Inspiratory Reserve Volume”; R. V. for â€Å"Residual Volume”; V. C. for â€Å"Vital capacitance”; FEV1 for â€Å"Forced Expiratory Volume”; T. L. C. for â€Å"Total Lung might”; and finall y, Pump Rate for the number of breaths per minute. 3. You may fool your data at both time by photographing Tools at the top of the screen and then write Data. You may also grade the hound on the cathode-ray oscilloscope monitor by clacking Tools and then stain graph. 4. Highlight the line of data you just record by riffing it and then claver Delete Line. . clink disentangle Tracings at the bottom right of the oscilloscope monitor. You are now ready to begin the first experiment. ¦ A C T I V I T Y 2 6. clatter exposed Tracings before proceeding to the next performance. Do not withdraw your recorded dataâ€you go forth need it for the next activity. ¦ A C T I V I T Y 3 Effect of Restricted Air Flow on Respiratory Volumes 1. Adjust the roentgen of the air liquify tube to 4. 00 mm by frumping the ( ) button next to the wheel spoke display. quote steps 2â€5 from the previous activity, making sure to click Record Data. How does this set of data compare to the data you recorded for body process 2?\r\nThe breathing isnt as strong ________________________________________________ the flow and tidal volume pretend lessen ________________________________________________ Is the respiratory system functioning emend or worse than it did in the previous activity? Explain why. functioning worse, it isnt moving as much air or expanding ________________________________________________ the lungs as far because of the decreased space for intake ________________________________________________ and output of air 2. jerk Clear Tracings. 3. Reduce the radius of the air flow tube by another 0. 0 mm to 3. 50 mm. 4. Repeat steps 2â€6 from Activity 2. 5. Reduce the radius of the air flow tube by another 0. 50 mm to 3. 00 mm. 6. Repeat steps 2â€6 from Activity 2. What was the printing of reducing the radius of the air flow tube on respiratory volumes? furthur decrease of flow and tidal volume ________________________________________________ _ _______________________________________________ What does the air flow tube simulate in the human body? windpipe ________________________________________________ ________________________________________________\r\nMeasuring Normal Respiratory Volumes 1. Make sure that the radius of the air flow tube is at 5. 00 mm. To adjust the radius, click the ( ) or ( ) buttons next to the radius display. 2. click the Start button. Watch the oscilloscope monitor. When the touch sensation reaches the 10-second mark on the monitor, click the ERV button to declare the expiratory reserve volume. 3. When the come after reaches the 30-second mark on the monitor, click the FVC to obtain the forced vital capacity. 4. Once the trace reaches the end of the screen, click the Stop button, then click Record Data. . flirt with, you may print your trace or your recorded data by clicking Tools at the top of the screen and selecting either Print graph or Print Data. From your recorded data, you can calcula te the minute respiratory volume: the amount of air that passes in and out of the lungs in 1 minute. The expression for calculating minute respiratory volume is: arcminute respiratory volume tidal volume beats per minute (breaths per minute) Calculate and enter the minute respiratory volume: _7,500________ Judging from the trace you gene estimated, inspiration in additionk place over how galore(postnominal) seconds? __2 seconds_____________ Expiration took place over how many seconds? What could be some possible causes of reduction in air flow to the lungs? obstruction, inflammation from illness or allergic ________________________________________________ reaction ________________________________________________ ________________________________________________ 7. shoot the breeze Tools > Print Data to print your data. _____2 seconds____________ Does the duration of inspiration or expiration vary during yes ERV or FVC? _____ Respiratory System Mechanics 91 FIGURE 7. 2\r\nOpenin g screen of the Factors Affecting Respiration experiment. Express your FEV1 data as a percentage of vital capacity by filling out the following chart. (That is, take the FEV1 value and divide it into the vital capacity value for each line of data. ) Factors Affecting Respiration Many factors affect respiration. Compliance, or the top executive of the chest wall or lung to distend, is one. If the chest wall or lungs cannot distend, respiratory ability will be compromised. Surfactant, a lipid hearty secreted into the alveolar fluid, is another.\r\nSurfactant acts to decrease the surface accent of water in the fluid that lines the walls of the alveoli. Without surfactant, the surface focus of water would cause alveoli to collapse after each breath. A third factor affecting respiration is any injury to the thoracic wall that results in the wall being deflated. Such a puncture would effectively raise the intrathoracic pressure to that of atmospheric pressure, preventing diaphragm con traction from decreasing intrathoracic pressure and, consequently, preventing air from being drawn into the lungs. disavow that airflow is achieved by the coevals of a pressure difference between atmospheric pressure on the outside of the thoracic cavity and intrathoracic pressure on the inside. ) We will be examine the effect of surfactant in the next activity. Click Experiment at the top of the screen and then select Factors Affecting Respiration. The start screen will look like Figure 7. 2. Notice the changes to the FEV1 as % of Vital electrical capacity Radius FEV1 Vital Capacity FEV1 (%) 5. 00 4. 00 3. 50 3. 00 3541 1422 822 436 4791 1962 1150 621 1. 35% 1. 37% 1. 39% 1. 42% ¦ 92 go 7 quipment above the air flow tube. Clicking the Surfactant button will add a pre-set amount of surfactant to the â€Å"lungs. ” Clicking flower will clear the lungs of surfactant. Also notice that valves have been added to the sides of each simulated lung. Opening the valves will a llow atmospheric pressure into the vessel (the â€Å"thoracic cavity”). Finally, notice the changes to the display windows below the oscilloscope screen. Flow remaining and Pressure Left refer to the flow of air and pressure in the left â€Å"lung”; Flow right(a) and Pressure Right refer to the flow of air and pressure in the right â€Å"lung. Total Flow is the sum of Flow Left and Flow Right. A C T I V I T Y 4 3. Click Flush to remove the surfactant from the previous activity. 4. Be sure that the air flow radius is set at 5. 00 mm, and that Pump Rate is set at 15 strokes/minute. 5. Click on Start and allow the trace to sweep the length of the oscilloscope monitor. Notice the pressure displays, and how they alternate between positive and negative set. 6. Click Record Data. Again, this is your service line data. 7. this instant click the valve for the left lung, which currently reads â€Å"Valve closed. ” 8. . Click Start and allow the trace to sweep the len gth of the Click Record Data. oscilloscope monitor. Effect of Surfactant on Respiratory Volumes 1. The data recording box at the bottom of the screen should be clear of data. If not, click Clear Table. 2. The radius of the air flow tube should be set at 5. 00 mm, and the Pump Rate should be set at 15 strokes/minute. 3. Click Start and allow the trace to sweep across the full length of the oscilloscope monitor. Then click Record Data. This will serve as the baseline, or control, for your experimental runs.\r\nYou may wish to click Tools and then Print Graph for a printout of your trace. 4. Click Surfactant twice to add surfactant to the system. Repeat step 3. When surfactant is added, what happens to the tidal volume? It increases the amount of air being inhaled ________________________________________________ As a result of the tidal volume change, what happens to the flow into each lung and total air flow? ________________________________________________ they all increase why does this happen? urfactant decreases teh surface latent hostility of water in the ________________________________________________ fluid that lines the walls of the alveoli ________________________________________________ Remember, you may click Tools and then either Print Data or Print Graphs to print your results. ¦ A C T I V I T Y 5 What happened to the left lung when you clicked on the valve button? why? The lung deflated due to the change in the intrapleural ________________________________________________ pressure ________________________________________________ ________________________________________________ What has happened to the â€Å"Total Flow” lay out? t trim down ________________________________________________ by half 0 What is the pressure in the left lung? ___________________ no Has the pressure in the right lung been affected? _________ If there was nothing separating the left lung from the right lung, what would have happened when you opened the valve f or the left lung? Why? both(prenominal) lungs would have collapsed due to pressure ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ directly click the valve for the left lung again, closing it.\r\nWhat happens? Why? nothing , there is excess air remaining in the lung ________________________________________________ ________________________________________________ Click Reset (next to the Flush button at the top of the air flow tube). What happened? the lung reinflated ________________________________________________ Describe the relationship infallible between intrathoracic pressure and atmospheric pressure in order to draw air into the lungs. intrathroacic pressure mustiness be greater or lower than ________________________________________________ atmospheric pressure to draw air in and out of the lungs ______________________________ _________________ Effect of Thoracic Cavity Puncture Recall that if the wall of the thoracic cavity is punctured, the intrathoracic pressure will equalize with atmospheric pressure so that the lung cannot be inflated. This consideration is known as pneumothorax, which we will check in this next activity. 1. Do not delete your data from the previous activity. 2. If there are any tracings on the oscilloscope monitor, click Clear Tracings. Respiratory System Mechanics 93 FIGURE 7. 3 Opening screen of the Variations in cellular respiration experiment.\r\n physique your own experiment for testing the effect of commencement the valve of the right lung. Was there any difference from the effect of opening the valve of the left lung? no ________________________________________________ Remember, you may click Tools and then either Print Data or Print Graphs to print your results. ¦ Variations in breathe Normally, alveolar ventilation keeps pace with the needs of body tissues. The eno ugh of alveolar ventilation is measured in monetary value of the partial pressure of carbon dioxide (PCO2). Carbon dioxide is the major component for regulating breathing rate.\r\nVentilation (the frequency of breathing multiplied by the tidal volume) maintains the normal partial pressures of oxygen and carbon dioxide both in the lungs and blood. Perfusion, the pulmonary blood flow, is matched to ventilation. The breathing strains of an individual are tightly regulated by the breathing centers of the header so that the respiratory and circulatory systems can work together effectively. In the next activity you will examine the effects of rapid breathing, rebreathing, and breathholding on the levels of carbon dioxide in the blood.\r\n fast breathing increases breathing rate and alveolar ventilation haves excessive for tissue needs. It results in a decrease in the ratio of carbon dioxide production to alveolar ventilation. Basically, alveolar ventilation becomes too great for the amount of carbon dioxide being produced. In rebreathing, air is taken in that was just expired, so the PCO2 (the partial pressure of carbon dioxide) in the air cell (and subsequently in the blood) is elevated. In breathholding, there is no ventilation and no gas exchange between the alveolus and the blood.\r\nClick Experiment at the top of the screen and select Variations in cellular respiration. You will see the next screen, shown in Figure 7. 3. This screen is very similar to the ones you have been working on. Notice the buttons for Rapid Breathing, Rebreathing, Breath Holding, and Normal Breathingâ€clicking each of these buttons will induce the given pattern of breathing. Also bring up the displays for PCO2, Maximum PCO2, Minimum PCO2, and Pump Rate. 94 Exercise 7 A C T I V I T Y 6 How does the rebreathing trace compare to your baseline trace? (Look conservativelyâ€differences may be subtle. ) ________________________________________________ Why? _______________________ ________________________ ________________________________________________ Click Clear Tracings to clear the oscilloscope monitor. ¦ A C T I V I T Y 8 Rapid Breathing 1. The oscilloscope monitor and the data recording box should both be empty and clear. If not, click Clear Tracings or Clear Table. 2. The air flow tube radius should be set to 5. 00. If not, click the ( ) or ( ) buttons next to the radius display to adjust it. 3. Click Start and conduct a baseline run. Remember to click Record Data at the end of the run. Leave the baseline trace on the oscilloscope monitor. 4.\r\nClick Start again, but this time click the Rapid Breathing button when the trace reaches the 10-second mark on the oscilloscope monitor. Observe the PCO2 levels in the display windows. 5. Allow the trace to finish, then click Record Data. What happens to the PCO2 level during rapid breathing? it decreased ________________________________________________ Why? carbonic acid gas was removed(p) more than durin g normal breathing ________________________________________________ ________________________________________________ Remember, you may click Tools and then either Print Data or Print Graphs to print your results.\r\nClick Clear Tracings before continuing to the next activity. ¦ A C T I V I T Y 7 Breath Holding 1. Click on Start and conduct a baseline run. Remember to click Record Data at the end of the run. Leave the baseline trace on the oscilloscope monitor. 2. Click Start again, but this time click the Breath Holding button when the trace reaches the 10-second mark on the oscilloscope monitor. Observe the PCO2 levels in the display windows. 3. At the 20-second mark, click Normal Breathing and let the trace finish. 4. Click Record Data. What happens to the PCO2 level during breath holding? t rose ________________________________________________ Why? co2 exchange could not take place ________________________________________________ _______________________________________________ _ Rebreathing Repeat Activity 6, except this time click the Rebreathing button instead of the Rapid Breathing button. What happens to the PCO2 level during rebreathing? it increase ________________________________________________ ________________________________________________ Why? there was more co2 in the inhaled air ________________________________________________ ________________________________________________\r\nWhat change was seen when you returned to â€Å"Normal Breathing”? the rate and depth of breathing change magnitude ________________________________________________ ______________________________________________ ¦ Remember, you may print your data or graphs by clicking Tools at the top of the screen and then selecting either Print Data or Print Graph. ¦ A C T I V I T Y 9 Comparative Spirometry In Activity 1, normal respiratory volumes and capacities are measured. In this activity, you will look what happens to these set when pathophysiology develops or during episodes of aerobic recitation.\r\nUsing a water-filled spirometer and knowledge of respiratory mechanics, changes to these value in each condition can be auspicateed, documented, and explained. Did the total flow change? just a little ________________________________________________ Why? increase pump rate ________________________________________________ ________________________________________________ Respiratory System Mechanics 95 FIGURE 7. 4 Opening screen of the Comparative Spirometry experiment. Normal Breathing 1. Click the Experiment menu, and then click Comparative Spirometry. The opening screen will come forward in a few seconds (see Figure 7. 4). 2.\r\nFor the patient role’s type of breathing, select the Normal option from the drop-down menu in the Patient guinea pig box. These values will serve as a basis of comparison in the affectiond conditions. 3. submit the patient’s breathing pattern as Unforced Breathing from the Breathing figure Opti on box. 4. after(prenominal) these selections are made, click the Start button and watch as the beat up starts turning and the spirogram develops on the paper rolling off the tucker across the screen, left to right. 5. When half the screen is filled with unforced tidal volumes and the trace has paused, select the Forced Vital Capacity button in the Breathing Pattern Options box. . Click the Start button and trace will continue with the FVC maneuver. The trace ends as the paper rolls to the right edge of the screen. 7. Now click on the individual measure buttons that appear in the data fudge above each data column to measure the lung volume and lung capacity data. Note that when a measure button is selected, dickens things happen simultaneously: (1) a bracket appears on the spirogram to predict where that measurement originates on the spirogram and (2) the value in milliliters appears in the data table.\r\nAlso note that when the FEV1 measure button is selected, the final column labeled FEV1/FVC will be automatically calculated and appear in the data table. The calculation is (FEV1/FVC) 100%, and the result will appear as a percentage in the data table. What do you think is the clinical importance of the FVC and FEV1 values? ________________________________________________ Why do you think the ratio of these two values is important to the clinician when diagnosing respiratory diseases? _______ demonstrates how the lungs are functioning ________________________________________________ FEV1 /FVC 100% 80% ______________________ 96 Exercise 7\r\n pulmonary emphysema Breathing In a person with emphysema, there is a significant outrage of intrinsic elastic complain in the lung tissue. This breathing out of elastic recoil occurs as the disease destroys the walls of the alveoli. air hose resistance is also change magnitude as the lung tissue in general becomes more flimsy and exerts less mechanical tethering on the surrounding flight paths. and then the lun g becomes besides compliant and expands easily. Conversely, a great effort is unavoidable to exhale as the lungs can no bimestrial passively recoil and deflate. A noticeable and severe muscular effort is required for each exhalation. Thus a person with emphysema exhales slowly. . Using this information, predict what lung values will change in the spirogram when the patient with emphysema breathing is selected. Assume that significant disease has essential, and thus a loss of elastic recoil has occurred in this patient’s lungs. 2. withdraw pulmonary emphysema from the drop-down menu in the Patient subject box. 3. Select the patient’s breathing pattern as Unforced Breathing from the Breathing Pattern box. 4. by and by these selections are made and the existing spirogram screen clears, click the Start button and watch as the fancy up starts turning and a virgin spirogram develops on the paper rolling off the drum. . Repeat steps 5â€7 of the Normal Breathing s ection in this activity. 6. Now consider the accuracy of your predictions (what changed versus what you expected to change). equationd to the values for normal breathing: reduced Is the FVC reduced or increased? ______________________ reduced Is the FEV1 reduced or increased? _____________________ fev1 Which of these two changed more? ____________________ Explain the physiological reasons for the lung volumes and capacities that changed in the spirogram for this condition. _______________________________________________ ________________________________________________ ________________________________________________ 1. Using this information, predict what lung values will change in the spirogram when the patient who is having an bang-up asthma attack attack attack approach shot is selected. Assume that significantly decreased airway radius and increased airway resistance have developed in this patient’s lungs. 2. Select wheezing from the drop-down menu in the Patient T ype box. 3. Select the patient’s breathing pattern as Unforced Breathing from the Breathing Pattern box. . After these selections are made and the existing spirogram screen clears, click the Start button and watch as the drum starts turning and a new spirogram develops as the paper rolls off the drum. 5. Repeat steps 5â€7 of the Normal Breathing section in this activity. 6. Now consider the accuracy of your predictions (what changed versus what you expected to change). Compared to the values for normal breathing: reduced Is the FVC reduced or increased? _____________________ reduced Is the FEV1 reduced or increased? _____________________ fev1 Which of these two changed more? ___________________ Explain the physiological reasons for the lung volumes and capacities that changed in the spirogram for this condition. ________________________________________________ ________________________________________________ How is this condition similar to having emphysema? How is the fvc is less reduce than emphysema and it different? ______________________________________ the fev1 is more reduced, the fcv/fev1 % is also reduced ________________________________________________ Emphysema and asthma are called obstructive lung diseases as they gear up expiratory flow and volume.\r\nHow would a spirogram look for someone with a restrictive lung disease, such as pulmonary fibrosis? decreased fev1/fev ________________________________________________ What volumes and capacities would change in this case, and would these values be increased or decreased? normal or above normal volume ________________________________________________ ________________________________________________ In an acute asthma attack, the compliance of the lung is decreased, not increased as it was for emphysema, and air flows freely through the bronchioles.\r\nTherefore, will the FEV1/ FVC percentage be less than normal, equal to normal, or high higher than normal? ________________________________ ______ Acute Asthma ardour Breathing During an acute asthma attack, bronchiole smooth muscle will spasm and thus the airways become squeeze (that is, they have a reduced diameter). They also become clogged with thick mucous secretions. These two facts put up to significantly increased airway resistance. Underlying these symptoms is an airway inflammatory response brought on by triggers such as allergens (e. g. , dust and pollen), total temperature changes, and even exercise.\r\n alike to emphysema, the airways collapse and pinch closed before a forced expiration is completed. Thus the volumes and peak flow rates are significantly reduced during an asthma attack. However, the elastic recoil is not diminished in an acute asthma attack. Respiratory System Mechanics 97 Acute Asthma Attack Breathing with Inhaler Medication Applied When an acute asthma attack occurs, many people seek embossment from the symptoms by using an inhaler. This device atomizes the medication and allows for direct application onto the afflicted airways. Usually the medication includes a smooth muscle relaxant (e. . , a beta-2 protagonist or an acetylcholine antagonist) that relieves the bronchospasms and induces bronchiole dilation. The medication may also contain an antiinflammatory agent such as a corticosteroid that suppresses the inflammatory response. Airway resistance is reduced by the use of the inhaler. 1. Using this information, predict what lung values will change in the spirogram when the patient who is having an acute asthma attack applies the inhaler medication. By how much will the values change (will they return to normal)? 2. Select addition Inhaler from the drop-down menu in the Patient Type box. 3.\r\nSelect the patient’s breathing pattern as Unforced Breathing from the Breathing Pattern box. 4. After these selections are made and the existing spirogram screen clears, click the Start button and watch as the drum starts turning and a new spirogram develops as the paper rolls off the drum. 5. Repeat steps 5â€7 of the Normal Breathing section. 6. Now consider the accuracy of your predictions (what changed versus what you expected to change). Compared to the values for the patient experiencing asthma symptoms: Has the FVC reduced or increased? Is it â€Å"normal”? ________ no no Has the FEV1 reduced or increased?\r\nIs it â€Å"normal”? _______ fev1 Which of these two changed more? ____________________ Explain the physiological reasons for the lung volumes and capacities that changed in the spirogram with the application of the medication. _________________________________ ________________________________________________ How much of an increase in FEV1 do you think is required for it to be considered significantly ameliorate by the not sure medication? _______________________________________ when the feve1 is impendent to normal? ________________________________________________ a. In moderate aerobic exercise, which do yo u predict will rv change more, the ERV or the IRV? _____________________ b. Do you predict that the respiratory rate will change yes significantly in moderate exercise? ____________________ c. Comparing dumb exercise to moderate exercise, what values do you predict will change when the body’s significantly increased metabolic demands are being met by the not sure respiratory system? _________________________________ ________________________________________________ d. During heavy exercise, what will happen to the lung volumes and capacities that have been considered thus far? hey will increase ________________________________________________ e. yes go away the respiratory rate change? If so, how? _________ 1. Select bind Exercise from the drop-down menu in the Patient Type box. The existing spirogram clears. 2. Click the Start button and watch as the drum starts turning and a new spirogram develops. Half of the screen will fill with breathing volumes and capacities for mod erate exercise. 3. When the trace pauses, click on the individual measure buttons that appear in the data table above each data column to measure the lung volume and lung capacity data. . Select Heavy Exercise from the drop-down menu in the Patient Type box. 5. Click the Start button and the trace will continue with the breathing pattern for heavy exercise. The trace ends as the paper rolls to the right-hand edge of the screen. 6. Now click on the individual measure buttons that appear in the data table above each data column to measure the lung volume and lung capacity data. 7. Now consider the accuracy of your predictions (what changed versus what you expected to change). Which volumes changed the most and when? ___________ Compare the respiratory rate during moderate exercise with that seen during heavy exercise. __________________ ¦ Breathing During Exercise During moderate aerobic exercise, the human body has an increased metabolic demand, which is met in part by changes in respiration. During heavy exercise, further changes in respiration are required to meet the extreme metabolic demands of the body. Histology Review Supplement For a polish up of respiratory tissue, go to Exercise H: Histology map collection & Review on the PhysioEx website to print out the Respiratory Tissue Review worksheet.\r\n'