Forecasting the Future of the US Economy Over the Next Year Research Paper

Forecasting the Future of the US Economy Over the Next Year - Research Paper Example However, the recovery of the U.S. has been expected to carry on, albeit at the sluggish pace (Elwell, 21). This paper is aimed at providing forecasts on the future of the US economic variables. Effects on economic variables: The level of inflation has been very high since 2007. This high level of inflation is now considered as the biggest problem in the country by the Fed. Due to this high level of inflation, consumers are not getting capable of purchasing costliest goods and services and hence business organisations which are engaged in production of these goods and services are leaving the industry. Again this is reducing the level of income in the country and hence the level of demand for necessary goods and service. The Fed is expecting to have a subdued in the next few years because of weaker level of real economic activities prevailing in the country. But the Fed is expecting to have a lower level of inflation rate in 2013 which is expected to increase the volume of economic ac tivities in the country. The Fed is expecting that the current rate of change in overall prices is expected to fall to 1% to 2% from its current level of 3% within five years. But the Fed is expecting that the rate of inflation will remain unresponsive in newt few years due to the fact the American economy is still under the curse of financial and economic crises situations (Minutes of the Federal Open Market Committee, 1). The Federal Reserve or Fed, in short, holds a very positive view regarding the current economic activities and the current condition of the financial market of the country. The chairman of the Fed, Dr. Ben S. Bernanke, has argued that after the global financial crisis of 2007-08, the American economy is experiencing greater volume of economic activities (Bernanke, 1). The IMF predicts the value of real GDP in the US to rise at 1.5% in 2011 (which is lower by1.0 percentage points than that of in June 2011 prediction) and at 1.8% in 2012 (which is lower by 1.1% tha n the June 2011 prediction) (Elwell, 21). The Open Market Committee of the Federal Reserve predicts the real GDP in the year 2012 to exist in the range of between 2.3% and 3.5% (the growth prediction for the year 2012 almost about 0.5 percentage points lower than that has been made in the June 2011). Also according to the Fed predictions the rate of unemployment is estimated to be in the range between 8.1% and 8.9% in the year 2013 (Fiscal Year 2013: Analytical Perspective: Budget of the U.S. Government, 19). Global Insight, which is a renowned economic forecasting private company, has recently predicted that the real GDP in the US will advance 1.4% by the end of 2012 (lower by 1.3 percentage points compared to its June 2011 estimation). The rate of unemployment in the country has been estimated to be around 9.3% in the year 2012 and 2013 (Elwell, 21). The level of FDI in the country is not expected to grow at much rapid speed compared to the past. In the global increasing in the am ount of FDI inflow to $1.4–$1.6 trillion in the year 2013, the US inflow of FDI is predicted to move in the range of $245 to $255 billion in 2013 (GLOBAL INVESTMENT TRENDS, 17). Again, it is expected by the researchers that the rate of interest will remain comparatively low as well as stable in the next year following the rapid growth of developing countries. This increasing growth of countries such as India and China will increase the volume of trade in favor of USA. Also the corporate bonds and

Solving Interpersonal Communication Problems Essay Example for Free

Solving Interpersonal Communication Problems Essay Everything that we do with other people involves communication such that all our social interactions are communicative and they presume communication processes. Interpersonal communication is characterized by: communication from one individual to another, communication which is face to face and both the form and content of communication reflect the personal characteristics of the individual as well as their social roles and relationships (Ellis, 2009). Interpersonal communication develops relationships of some sort among the communicating parties for instance when there is high degree of trust among them, where each person is prepared to openly discuss their feelings and where the participants have a mutual liking toward each other (Hartley, 2005). In this case the kind of relationship created is that of teacher to student relationship. Both the teacher and the student have the responsibility of seeking clarification whether they understand each other to minimize conflicts between them. Interpersonal communication is always a two way process meaning that two parties must be involved. The parties pass messages to each other such that there is the sender and the recipient but this is not static since the sender also becomes the recipient to complete the communication process (Hartley, 2005). The geography teacher in this case acts as the source when teaching and the students as the recipients. On the other hand the situation can be reversed where the student becomes the source and the teacher the recipient, this happens when the student seeks clarification. Interpersonal communication is an ongoing process and not an event. However, during the process of communication several things may happen that may hinder or create problems such that the parties do not communicate as intended. In most cases these problems are termed as noise in the process of communication. They hinder the sender and the recipient from decoding the words and signs sent leading to misinterpretation of each other hence passing the wrong messages. For instance in the case where the geography teacher intends to communicate to students on probable examinable questions yet some other students do not understand the teacher and even though they are hardworking they end up failing the exam. In this scenario it can be concluded that some noise existed between the teacher and the students and the intended message was not communicated. The existence of communication problem between the teacher and the father of the student may be said to have resulted from anger of the father due to the son’s failure in the test and the information availed to the father by the son. The remedies to this interpersonal communication will also be discussed later in the paper. Problems of interpersonal communication Language barriers The complexities of language codes are often highlighted in communication across cultural boundaries. There are number barriers in interpersonal communication that are related to language. Among the most common include; lack of equivalent words where the sender and the receiver comes from different cultural backgrounds and they use same word to mean different things (Ellis, 2009), lack of equivalent grammar or syntax this may make the parties in the communication to misinterpret the information forwarded by each other. For instance same words may work as nouns or verbs or adjectives for example in English `lift a thumb’ or `thumb a lift’ in the first case the word a `thumb’ is a noun and in the second case a `thumb’ is verb. Use of idioms and similes may also cause misunderstanding as different culture use them differently. Pronunciation is also a major problem in interpersonal communication this may alter the meaning of the word for instance problems associated with pronunciation of `r’ and `l’ one may pronounce ‘right’ as `light’ (Bovee Thill, 2000). In a class context such pronunciation problems may make the students fail to communicate as intended. The language problems in the communications process are thus very common in classrooms for instance it’s common to find student having different class notes as they hear different things from their teachers. The language used by the geography teacher may have not been understood by the student who failed in the test; this creates a conflict between the student and the teacher and it’s escalated further to family of the student. Use of non-verbal signs Non-verbal communication is a type of communication which consists of unspoken cues that a communicator sends in conjunction with spoken or written message for example, a person’s tone of voice where the individual vary the tone of the voice by either making it loud or sharp, facial expression, eye behavior, head nodding, nose thumbing, thumb movement. In addition one’s postures and manner of walking also may have communication significance for instance a person may walk in a manner which indicates utter despair. Also the distance between two individual involved in private conversation shows the relationship between the two (Turner West, 2008). It is therefore the responsibilities of the receiver and the sender to decode the message passage so as to avoid misunderstanding. The receiver decodes and interprets the message sent and responds by sending back feedback which helps the sender to find out if the receiver has correctly interpreted the message. The problem arises where the receiver misinterprets the message sent since he or she will respond by wrong feedback. Such misinterpretation may arise since individual comes from different cultural background and a certain non-verbal communication may have a totally different meaning to other cultures, for instance nodding of the head in some culture symbolizes acceptance or agreement but in some cultures it symbolizes disagreement (Kalefleisch,1993). In a class context the teacher’s changes of tones, facial expressions or uses cues that they think will help them to communicate effectively. In hinting what topic will appear in the tests the expression made by the geography teacher may have been misunderstood by the students resulting in students revising in other topics which made them to fail the exam. Use of nonverbal cues at times thus poses a bid problem in interpersonal communication. Channel noise This problem is caused by physical barriers and is mostly due to our senses of smelling, touching, tasting, hearing and seeing. Among the common channel noise includes laughing talking, coughing, sneezing, and snoring such noise can be inside or outside the setting of the source and the recipient of the message. For instance an aircraft over a building or a lawn mower outside a classroom, people talking or yelling loudly in the hallways or outside windows it can be even murmuring of students in class in the class students noting may distract other from listening (Ellis, 2009). The speaker may also not be audible enough, may have inappropriate appearance or have bad mannerisms that contribute to poor communication with the audience. If the speaker keeps on jingling his keys from the pockets this is still noise that may distract effective communication (Campbell Nelson, 2010). A school has many activities going on at the same time for instance cleaning of pavements, students moving up and down to laboratories and respective classes, cutting or trimming of hedges outside the classroom or continuous murmuring or laughing of students in class. All these distract the student in one way or the other from the teacher hence causing the student to miss some of the teacher’s remarks. This means that communication is not effective. May be such noises distracted the student when the geography teacher hinted on the topic to appear in tests and this made the student not to capitalize on the hinted topic hence failing an exam which became the source of the conflict. Psychological noise/emotional problem It also presents barriers to communication. Nervousness and anxiety can sometimes in certain situations be barriers to communication as well as tension that may be caused by controversy or conflict. The source of the message may use words or phrases that may be viewed negatively by the other party. The topic of discussion may also be controversial or no appealing to the other party or the audience may feel that the speaker is biased hence he may lack interest in listening to the speaker (Hartley, 2005). On the other hand the topic of discussion may be boring and the person trying to communicate may also be boring this may make even the listener to start dozing or sleeping hence unable to hear the speaker’s main points. It also true that some people may not like the person trying to pass messages and so they pay little attention no matter the message intended to be communicated. At times psychological noise may result from the audiences habit of thinking of what is to happen next for instance may be they also have to address the audience or they have a test in the near future or the events that happened sometimes back. Fatigue, stress or sometimes wrong timing for instance too early in the morning, too close to lunchtime or too late in the day when the listener are tired and the listeners may be faking attentiveness hence not decoding the message (Huff, 2008). In class context for instance student fakes attentiveness to avoid being punished or to please their teachers. Such cases, the teacher may be cheated that the student have understood the message being passed to students yet this is not the case .The teacher leaves satisfied that the message has been passed. In our case the student who is failed to pass the test may had psychological problems when the teacher was explaining on the examinable topics in the tests hence failed to decode the message that was being passed on this left the teacher with the impression that all students were attentive and would pass exams if they capitalized on the taught areas but this was not the case since some students end up failing the test. In addition the problem of the communication between the teacher and the father of the student who failed the exam resulted from the irritation of the father due to his sons failure in the test, misunderstanding occurs when the father feels that the teacher has resp onsibility of making the student pass the test while may be the teacher felt that he communicated effectively to students on what to expect in the tests. Solutions to interpersonal communication problems Language problems should at all times is avoided when communication is taking place between individuals but the major concern is how to avoid them. The parties in a communication exercise should ensure that they use the words that have similar cross-cultural meanings so that misinterpretation is avoided. Use of idioms, similes and other figurative languages should also be avoided and if used they should explained and made sure that the recipient understands the message fully (Fussel Kreuz, 1998). Pronunciation problems can be avoided by the source only if he practices to pronounce words properly however in some contexts like in a class pronunciation can be solved by spelling the words used or writing on the board so that communication is made effective. In addition to these language problems the teacher should understands the language problems of his students so that assistance is given in special cases as the instincts of the teacher feel that they may not comprehend the terms used . Non-verbal cues are inherent in any communication process and people should not always assume that they understand what gestures means otherwise the fail to comprehend the message sent. In order to avoid the problems associated with nonverbal signs the recipient should pay attention to what is being said since most nonverbal cues are aimed to emphasize a verbal message. For instance in class context a teacher may raise the voice to underscore something previously said. In addition it should be made sure that nonverbal and verbal messages match to avoid miscoding and misinterpretation. People should also be tentative in interpreting nonverbal communication due to the cultural differences in nonverbal cues. It also advisable to avoid non-verbal distractions when communicating since it at times act as noise in interpersonal communication. For instance shifting your eyes or continuously playing with one’s hair may add other meanings in the message being conveyed. Non-verbal signs should also be put in context when using them. Attention should pay on non-verbal cues but they should place in the right context. To understand what nonverbal cues means one should consider the entire communication process not just on element of it and we also need to ask others about what certain nonverbal cues mean in their culture (Turner West, 2008). In order to avoid psychological problems in interpersonal communication it advisable that to ensure that the parties in the communication process are psychologically prepared and they understand each other situation to avoid conflicting communication. The parties in the communication process should ensure that their topic of discussion is relevant, not boring and well timed to avoid distractions to other issues. It’s also advisable that all parties are actively engaged for instance in class the teacher should engage students with questions to make sure that they do not fake attentiveness. In addition the case of parent teacher miscommunication, the parent should always be psychologically prepared that a student can fail or pass a test and it’s not always the fate of a teacher for student failure. To avoid psychological problem in interpersonal communication the parties should ensure that they know their feelings, analyses the situation, owning their feelings reframing w hen needed and empathizing such practices are complex activities that involve sensitivity, awareness, insight and empathy therefore just like any proficiency, emotional communication require patience and persistence (West Turner, 2008). Solution to the channel noise can only be rectified by making sure the right channel to communication is used. The parties in the communication process should ensure that conducive environment exists so that communication is effective. In this case internal settings of the class should have minimal noise only that cannot be controlled. The teacher should take the responsibility of ensuring source of noise such as murmuring is minimized; however little can be done on external settings since other activities must take place (Aswathappa, 2005). If in our case external noise is too high the teacher ought to raise his voice or the student to have asked the points missed for effective communication to take place. Conclusion Interpersonal communication is vital in developing relationships among individuals since every social interaction involves communication. As said earlier it involves at least two individuals passing messages to each other. Individual must be ready to express their feelings and emotions for interpersonal communication to be said to occur. It’s a cyclic process that is continuous from source to recipient and vice versa where the recipient becomes the source and the source the recipient for the process to complete. Interpersonal communicational though very important and inevitable in our day to day activities has certain problems that hinder effective communication to occur between individuals. These problems include: Language problems, channel related problems, non-verbal cues interpretation problems and psychological and emotional problem such as anger love and pretense. These problems if not well checked makes the communication between individual to deviate from the original intentions and they need to be checked every time individuals are communicating to avoid conflicts for instance the one that emerged between the teacher and student. Read more: http://www.ukessays.com/essays/english-language/solving-problems-of-interpersonal-communication-problems-english-language-essay.php#ixzz2LX8NPmck

Hypoglycaemia in a Term Infant Form Diabetic Mother

Hypoglycaemia in a Term Infant Form Diabetic Mother Hypoglycaemia in a term infant form diabetic mother ASSIGNMENT TITLE: Critically analyse the care provided to an infant from a diabetic mother and family The following assignment will discuss the care of an infant within a special care baby unit, the care provided will be critically analysed and local, national guidelines and recent research associated with the care of the infant will be discussed. In order to ensure confidentiality and in accordance with Nursing and Midwifery Council (2015) the infant being discussed will be referred as Infant B. for the purposes of this assignment the nursing framework Casey, A. (1988), will be used. Casey model includes child, family, health, environment and nurse however to personalize the care provided the main focus within this assignment will be concerning blood glucose control though, temperature control, minimized pain, maintaining a safe environment, establishing feeds, communication and family centred care will be discussed as well in relation to blood glucose control. The rationale supporting the use of Casey model is said to focus on family centred care that is redefining the relationships in health care, increasing and becoming one of the main goals on the neonatal units across the world (Staniszewska et al., 2012). Casey, A. (1988) acknowledges the vital role of the parents and family and ensures the everyday care of the child through a partnership and negotiation between parents and family and the nurse (Casey and Mobbs, 1988; Patient- and Family-Centered Care and the Pediatricians Role, 2012). This assignment is focused on the care of infant B, born at term at 41 weeks and two days gestational age within an antenatal diagnosis of maternal diabetes mellitus type I with a birth weight of 3140 grams, over two consecutive night shifts. Admitted to special care with one day of life with diagnosis of hypoglycemia one of the most frequent causes of admission in this sector (NHS Improvement, 2016). The assessment of infant B. was performed at the moment of admission on the first day after transferred from post-natal unit as per Trust policy. An adequate assessment is a crucial component of nursing practice, mandatory for planning and provision of patient and family centred care (Staniszewska et al., 2012) fundamental for their professional accountability and responsibility RCN (2014.) IDM according with UNICEF (2013) are at risk and need to be correctly identified and managed appropriately. The definition of hypoglycemia in the newborn infant has remained controversial because of a lack of significant correlation among plasma glucose concentration, clinical signs, and long-term sequelae (WRIGHT and MARINELLI, 2014; Hay, et al 2009; UNICEF, 2013) Bulbul and Uslu (2016) concluded that there has been no substantial evidence-based progress in defining what constitutes clinically important neonatal hypoglycemia, particularly regarding how it relates to brain injury. However they consider clear the definition of transient and persistent hypoglycemia and their differences (Cornblath et al.,2000). Many authors have suggested a numeric definitions of hypoglycemia that are variable in postnatal age (Cornblath and Ichord, 2000; Harris at al, 2012; Hawdon 2013; Arya at al, 2013; Stomnaroska-Damcevski, 2015; Adamkin, 2016). The value 2.6mmol/l was adopted by many clinicians and by the Trust as well, however there is no scientific justification for this value (Wright and Marinelli, 2014). On admission infant B. presented with a low blood glucose level (BGL) of 1.3mmol/L, In order to increase blood glucose level, a peripheral venous line (PVL) was inserted in right foot as per Trust policy (2012) (NICE,2015), 10% Dextrose bolus administered, started intra venous fluids of 10% Dextrose and a nasogastric tube inserted. Blood glucose level checked 30mins after (NICE, 2015), level increased to 3.1 mmol/l. IV fluids started (60ml/kg/day) (NICE, 2015; BNF, 2015) and BGL checked 1-2 hours after. Frequency was based on infant B condition (Stomnaroska-Damcevski et al, 2015). Dextrose 10% is given to restore blood glucose levels and provide calories minimizing liver glycogen depletion (BNF, 2014). Administration of a 10%Dextrose is protocoled but this value, once more, it is not consensual in literature (BNF, 2010; Arya at al 2013; Adamkin, 2016). A bolus was given first, with higher concentration that infusion, to increase quicker the values and followed by the infusion to stabilize the levels (Adamkin, 2011). The goal is to achieve a blood glucose level of 2.6 to 9mmol/L (Rennie and Kendall, 2013). Frequent Dextrose bolus are not recommended (WHO, 1997) per risk of hyperosmolar cerebral oedema. A study developed by Heagarty (2016) showed significant benefits of oral dextrose gel as an option for treatment of symptomatic hypoglycemia. Shows that is most effective, well tolerated and reduce 50% the incidence of neonatal hypoglycemia in high risk infants, but just for newborn babies in postnatal unit, not indicated for NICU admissions due to severity conditions (BNF, 2015). Hawdon et al (1994) describe a persistent effect and side-effects, and high doses can stimulate insulin release, that can be a reason why oral glucose gel it is not used in NICU. Other option is glucose water however studies (Wight and Marinelli, 2014) indicate that has insufficient energy and lack of protein. At delivery, glucose supply from mother to the infant stops, and consequently glucose concentrations decrease rapidly, until a exogenous source of glucose is available, the infant depends on his hepatic glucose production to face metabolic needs and maintain the homeostasis during the first few days (Boissieu et al. 1995; de Rooy and Hawdon, 2002). The pediatric endocrine society considers the first 48h of a health newborn infant a normal period of transitional hypoglycemia (Cornblath and Ichord, 2000; Merenstein and Gardner, 2011). Low ketones levels, inappropriate preservation of glycogen, and low glucose levels, are characteristics of this period and may activate mechanisms for brain protection (Adamkin, 2016; Standley, et al, 2016). Acute neurophysiological changes occur when human neonates are low in BGL and the long-term significance of these acute changes is not clear (Cornblath and Ichord, 2000). The presence of risks factors, as an infant from a diabetic mother (Rennie and Roberton, 2013) predisposing an infant to hypoglycemia, and increase the risk of persistent hypoglycemia (Thornton et al., 2015). Highlighting the risk factors may determine an appropriate management and a proper planning since the delivery (Lang, 2014) and according with UNICEF (2013) IDM are at risk and need to be correctly identified and managed appropriately. Based on this we can consider infant B a high risk baby to develop hypoglycemia with risk for persistent hypoglycemia. As an IDM, infant B. developed in postnatal period a hypoglycemia episode, this can be considering a transitional hypoglycemia that is caused by hyperinsulinemia (Stanley at, 2015). A study developed by Isles, Dickson and Farquhar (1968) suggests IDM removes glucose quicker than babies from a non-diabetic mother, and that comes from the ability to produce more insulin based on memory of levels experienced in utero. Hyperinsulinism is the most common cause of increased utilization of glucose, and can be temporary, for example when the fetus has been in contact with a hyperglycemic environment by poorly controlled maternal diabetes, (Rennie and Roberton, 2013). In this stage is important to screen for transient and persistent hypoglycemia, the last one with high risk to develop permanent hypoglycemia and consequently induced brain injury (Adamkin, 2011). Neonatal hypoglycemia is commonly asymptomatic but non-specific and extremely variable signs can be presented (Merenstein and Gardner, 2011). In the Trust we apply N-PASS scale to assess pain, agitation and sedation (Hummel et al, 2004) Neurological manifestation as irritability, jitteriness, lethargy, seizure and cardiorespiratory manifestations like cyanosis, pallor, apnea, irregular respirations, tachypnea and cardiac arrest can be presented. Infant B on admission had an appropriate crying not irritable, appropriate behavior, relaxed facial expression, normal tone and with vital signs in normal range. N-PASS scale was applied every three hours when vital signs evaluated, on every procedure and every time that was appropriate. Hypoglycemia cannot be defined only based on single BGL, has to contextualize with infant and mother history (Cornblath and Ichord, 2000). A study developed by Eidelman and Samueloff (2002) associate directly physiopathology of an IDM with metabolic processes including fetal hyperglycemia and fetal hyperinsulinemia, this fetal hypermetabolic state promote somatic growth, obesity, and metabolic disturbance in short and long-term consequences. Diabetic control early in pregnancy is associated with normal neurodevelopment outcome, but according with Schwartz and Teramo, (2000), blood glucose control increases their importance during the pregnancy and especially during the labor and delivery. IDM according with WHO (1997) as high risk for hypoglycemia however, Hawdon (2015) and NICE (2015) says if prenatal and intrapartum are followed by a specialist and monitored this babies should be treated in a first approach as a low risk infant, and the baby can stay with the mother after birth to monitor BGL for 24h or 12h if stable (Adamkin, 2011). IDM is not an indication to be admitted in the neonatal unit. Managing a baby asymptomatic with confirmed hypoglycemia relies on continuing breastfeeding but now more frequently (Amended, 2015), feed 1-3ml/kg (up to 5ml/kg if needed) of expressed breastmilk (EBM) or substitute nutrition (formula, donor human milk) (NICE, 2013; Hegarty, 2016). Increasing frequency will provide more colostrum for the baby, will stimulate the breast to produce more milk, its a moment to practice skin-to-skin, provides a relaxing healthy moment for both encouraging bounding (Adamkin, 2016) Infant B. developed hypoglycemia in post-natal unit and formula milk was started, to receive proper neonatal care had to be separated from mom. This fact interfered with breastfeeding, production of breast milk and bonding between mother and newborn (Sparshott, M., 1997). Mother B didn ´t have any milk production and that was a trigger for a stressful situation. Assessment of knowledge of all situation was done; emotional support was given, educated and encouraged to continuing breastfeeding, explained importance of breastmilk. Colostrum is the first milk produced by a mother, as a high concentration of nutrient and sugar and ideal to help blood glucose level to reach acceptable values (Wight and Marinelli, 2014). Breastmilk is preferred to formula for association with increase of ketones production (Hawdon et al 1992) and lower blood glucose values in term babies fed with formula, related with insulinogenic effect of protein in formula (Lucas et al, 1981). In partnership with mother B. was planned to stop formula milk when possible and all the EBM expressed was given to infant B. Encourage skin-to-skin contact and unlimited access to breast. (Wight and Marinelli, 2014) It is extensively documented in the literature (Tessier, (1998); Almeida et al., 2010; Heidarzadeh et al., 2013; Blackman, 2013) that kangaroo care provides health benefits not only for the infant but also for parents. A study performed by Heidarzadeh et al. (2013) conclude 62.5% of the mothers that provide kangaroo care to their babies were discharged from the hospital exclusively breastfeeding their babies, comparing with 37.5% of the group that didnt provide kangaroo care. Almeida et al. (2010) in a similar study concludes 82% on discharge go home exclusive breastfeeding. Blackman in 2013 performed a study where one of the subjects evaluated was blood glucose level when provided kangaroo care and results were significantly higher comparing with infants that didnt rece ived. Tessier in 1998 cit by Poppy Steering Group (2009) conclude kangaroo care reduce maternal anxiety, and increase a mothers sense of competence and sensitivity towards her infant. After birth, one of the most important changes is related with metabolism energy and thermoregulation. Infant B. is a term baby however, is a newborn and the risk of disturbance of the thermoregulation is present (Arya at al 2013). A newborn after birth, loses heat immediately by evaporation, convection, conduction and radiation, dependent on the ambient air pressure, temperature and humidity and the temperature of surrounding surfaces (Waldron and Mackinnon, 2007) The newborn has an ability to control and balance temperature, glucose and oxygen perfusion constitute the energy triangle (Aylott, 2005) Variations in this gradual transition can result in disturbances of the neonate regulation such as neonatal hypoglycemia or hyperglycemia. Infant B. had initially presented with an axilla temperature of 37.1 °C, normothermic according with World Health Organization (2006), whilst nursed in an open cot. To prevent variations in temperature infant B. was dressed with a vest and Babygro, a hat and wrapped with a shawl and a light blanket on top NHS (2015) and nursed away from draughts and windows to reduce heat loss by convection (Vilinsky and Sheridan, 2014). Furthermore, care was taken to reduce over exposure of the infant due to procedures, as minimize handling and promoting kangaroo care. World Health Organization (1997) describes kangaroo care as a method to keep babies warm and improve the experience during painful procedures as heel pricks (Johnson, 2007). In order to avoid overheat, as Trust policy, temperature was monitored every three hours by use of a tempadot placed under the axilla for 3minutes and room temperature was set at 24-26 °C. It is essential that neonates are nursed within their neutral thermal environment, defined as a temperature where a baby with normal body temperature has a minimal metabolic rate and minimal oxygen consumption (Waldron and Mackinnon, 2007). Hypothermia can lead harmful effects as hypoglycemia, respiratory distress, hypoxia, metabolic acidosis and failure to gain weight (McCall et al, 2010). During this two night shift, Infant B. was able to maintain his temperature. Detect pain in a neonate it ´s a challenge for multiple factors, a complete and efficient evaluation results in an adequate plan of interventions. As referred previously, N-PASS scale it is adopted by the Trust as a tool to assess pain in neonates. Infant B is exposed to frequent acute pain for heel pricks for evaluation of BGG and cannula in left foot. On admission pain score 0 but during the procedures pain score 1 with consolable crying, tachypneic, tachycardic and clenched Non-nutritional sucking with and without sucrose, swaddling or facilitated tucking and kangaroo care are non-pharmacological techniques adopted to minimize pain to infant B. (2016). Non-nutritional sucking demonstrates to be effective to calm and decrease, particularly mild and moderate pain experienced by the neonate and behaviour responses to pain (Liaw et al., 2010). Baby regulates and organizes himself and relief pain through sucking with no nutritional intake objective. Sucrose effect is mediated by endogenous opioid pathways activated by sweet taste (Gibbins and Stevens, 2001). Beyond non-nutritional sucking, others interventions can be applied, and most of them in partnership with family and parents. Individualised developmental care to include family, explained how to reposition the baby in a comfortable way, swaddling and nesting, and during the procedure containment holding. Encourage parents to touch the neonate and talk with him. If the procedure allowed, do kangaroo care. Minimize painful procedures and clustering, discuss with parents schedules and develop a plan with team. Manipulate the environment decreasing noise and light (Sparshott, 1997). An approach based in recognition and appreciation of parents roles, siblings and other family member allow the nurse to recognise critical steps on the care pathway (Staniszewska et al., 2012) Maximising opportunities for communication with parents/ family increasing confidence in role as a parent and supporting parents-infant relationship. Within the special care unit family-centred care is essential as is advocated by the unit in which the care was being received. During this episode infant B. was placed in a normal cot, because he is a term infant and able to maintain his temperature. This fact allowed his mother as well to be more closed, with no physical barriers. The poppy Steering group (2009) indicate through the needs of parents with an infant requiring neonatal support, the findings show that parents need to have the opportunity to get to know their babies, emotional support, involvement in care and decision making and to establish effective communication with health care staff. When mother B. was able to attend the unit she appeared worried and anxious about not being with infant B. in port-natal ward. It was clear that she saw the change to a different place as a barrier. Explained that she can stay all day and night with infant B. only in handover time, she need to leave for 30 mins, was discussed the bette r time for cares and handling the baby for procedures. Infant B. father was not in the unit during the night, went home to rest, nursing staff were the only support available to her. A study developed by the poppy steering group (2009), showed evidence that improved communication and involvement in their baby ´s care promotes positive parent-child interaction and attachment. It is important for them to have the opportunity to spend time with their baby and know them in partnership with the nurse that is responsible to provide emotional support and provide involvement in care being open to discuss decisions to be made and stablishing effective communication. Mother B. referred that the possibility to do skin-to-skin when it is appropriate for her and for her baby, helped her to cope with sensation of losing control of her baby. Create opportunities for the mom to feel participative in the care, especially during feeding time, like helping with nasogastric feeding encourage bounding and promote attachment in situations of separation between mother and infant. (Bliss, 2011) In second night shift Infant B. remains on IV fluids, intravenous infusion rate was increased to 90ml/kg/day, as per Trust policy. Infant B was able to maintain blood glucose levels between 3.1-4.2mmol/L. Following Trust guidelines supported by NICE (2015), glucose measurements are now twice a day after two consecutive measurements above 2.6mmol/L if infant B developed symptoms of hypoglycemia frequency will be increased. Stablishing breastfeeding but followed by top up ´s through nasogastric tube (2mls every 2 hours) (Wight and Marinelli, 2014) given all EBM available and formula milk to achieve amount of milk that infant B needs. Intravenous fluids as decreased as feeds increased, titrating, to meet infant B intake requirements. Infant B was tolerating well his feeds, abdominal not distended and soft, minimal milky aspirates the plan is normalizing baby, decreasing amout of fluid given by intravenous line and increase feeds hoping baby can return to post-natal unit in the next day. Screening high risk babies is other controversial intervention. A utilization of a tool to screen universally IDM after birth will allow more accurate assessments. NICE, 2013 preconize a standard approach, considering IDM healthy babies until any underling condition appears. However Stomnaroska-Damcevski et al (2015) thinks that assessment is important and. Tools like CRIBS and SNAPPE both based in specific criteria but different between should be used. BGL checked by test-strips provides a estimative value, vary 0.5-1mmol/l (Hay et al, 2009) laboratory enzymatic methods is the most accurate method, but results not quick enough for rapid diagnosis, delaying potential interventions and treatment. A Test-strips is important but must be confirmed by a laboratory testing, however the treatment shouldnt be delayed in order to wait for the values, preventing neurologic damage. (Polin, Yoder and Burg, 2001, Adamkin, 2011) All literature consensual in therapeutic through IV dextrose bolus, and IV dextrose continuing infusion, increasing to 12.5% dextrose if values not stable (NICE,2013; Stomnaroska-Damcevski et al ;2015) but when start therapeutic interventions remains not clear. Need more research about oral glucose gel, and more studies about hypoglycaemia to try to understand values of reference and what is dangerous for infant. NICE, 2013, recommends an individualized approach to management with treatment personalized to the specific disorder, taking in mind patient safety and family preferences. Ungraded best practice statement. The available studies are inconclusive and ambivalent about the subject of hypoglycaemia. Primary studies about blood glucose levels are old, and that fact can compromised the conclusion of the case study for up to date resources. Flexibility of sources becomes easy to get lost in the main questions. A case study it ´s about a particular subject and become individualized losing the relevance. However the context of the phenomenon subject of study is explored in its context with is significance and understanding (Gerrish, K. and Lacey, 2006). This subject is something that we expect to see improving and more reflexion about practice. Diversity of literature helps contextualize diferent prespective through the time. Explain to women with insulin-treated pre-existing diabetes that they are at increased risk of hypoglycaemia in the postnatal period, especially when breastfeeding, and advise them to have a meal or snack available before or during feeds. [2008] To test BGL, in the Trust, it is used Bedside glucose reagent test strips, according with Akalay et al (2001) this are inexpensive and practical but are not with significant variance from true blood glucose levels, especially at low glucose concentrations. Ho et al (2004) preformed a study with five different glucometers, concluding that alone they are not sensitive enough to do a diagnose, just for initial assessment, advising a laboratory analysis to be more accurate. Tools para haver tools tinham de diferentes para cada grupo de risco (Harris, 2012) References AACN., NANN., AWHONN., and Watson, R. (2014). Certification and Core Review for Neonatal Intensive Care Nursing. 1st ed. Elsevier Health Sciences. Adamkin, D.H. (2016) Neonatal hypoglycemia, Seminars in Fetal and Neonatal Medicine, . doi: 10.1016/j.siny.2016.08.007 Adamkin, D.H. and Polin, R.A. (2016) Imperfect advice: Neonatal hypoglycemia, The Journal of Pediatrics, 176, pp. 195-196. doi: 10.1016/j.jpeds.2016.05.051 Al-Agha, R., Firth, R., Byrne, M., Murray, S., Daly, S., Foley, M., Smith, S. and Kinsley, B. (2011). Outcome of pregnancy in type 1 diabetes mellitus (T1DMP): results from combined diabetes-obstetrical clinics in Dublin in three university teaching hospitals (1995-2006). Irish Journal of Medical Science, 181(1), pp.105-109. American Academy of Pediatrics and College of Obstetrics and Gynecologists. Guidelines for Perinatal Care. Elk Grove Village, IL: American Academy of Pediatrics; 2012. Armentrout, D. and Caple, J. (1999). Newborn hypoglycemia. Journal of Pediatric Health Care, 13(1), pp.2-6. Arya, V., Senniappan, S., Guemes, M. and Hussain, K. (2013). Neonatal Hypoglycemia. The Indian Journal of Pediatrics, 81(1), pp.58-65. Aylott, M. (2006a) The Neonatal energy triangle part 1; Metabolic adaptation. Paediatric Nursing. 18, 6, 38-42 Casey, A., 1988. A partnership with child and family. Senior Nurse 8(4), 8-9 Cho, H.Y., Jung, I. and Kim, S.J. (2016) The association between maternal hyperglycemia and perinatal outcomes in gestational diabetes mellitus patients, Medicine, 95(36), p. e4712. doi: 10.1097/md.0000000000004712 Clinical Features of Neonates with Hyperinsulinism. (1999). New England Journal of Medicine, 341(9), pp.701-702. Corkin, D., Clarke, S. and Liggett, L. (2011). Care planning in children and young peoples nursing. 1st ed. Chichester, West Sussex, UK: Wiley-Blackwell. Cornblath M, Hawdon JM, Williams AF, Aynsley-Green A, Ward Platt MP, Schwartz R et al. (2000) Controversies regarding definition of neonatal hypoglycaemia: suggested operational thresholds. Pediatrics; 105: 1141-5. Cornblath, M. and Ichord, R. (2000). Hypoglycemia in the neonate. Seminars in Perinatology, 24(2), pp.136-149. Cornblath, M., Hawdon, J., Williams, A., Aynsley-Green, A., Ward-Platt, M., Schwartz, R. and Kalhan, S. (2000). Controversies Regarding Definition of Neonatal Hypoglycemia: Suggested Operational Thresholds. PEDIATRICS, 105(5), pp.1141-1145. de Boissieu, D., Rocchiccioli, F., Kalach, N. and Bougnà ¨res, P. (1995). Ketone Body Turnover at Term and in Premature Newborns in the First 2 Weeks after Birth. Neonatology, 67(2), pp.84-93. de Rooy, L. and Hawdon, J. (2002). Nutritional Factors That Affect the Postnatal Metabolic Adaptation of Full-Term Small- and Large-for-Gestational-Age Infants. PEDIATRICS, 109(3), pp.e42-e42. DePuy, A.M., Coassolo, K.M., Som, D.A. and Smulian, J.C. (2009) Neonatal hypoglycemia in term, nondiabetic pregnancies, American Journal of Obstetrics and Gynecology, 200(5), pp. e45-e51. doi: 10.1016/j.ajog.2008.10.015. Deshpande, S. and Ward Platt, M. (2005) The investigation and management of neonatal hypoglycaemia, Seminars in Fetal and Neonatal Medicine, 10(4), pp. 351-361. doi: 10.1016/j.siny.2005.04.002. Eidelman, A. and Samueloff, A. (2002). The pathophysiology of the fetus of the diabetic mother. Seminars in Perinatology, 26(3), pp.232-236. Feldman, A. and Brown, F. (2016). Management of Type 1 Diabetes in Pregnancy. Curr Diab Rep, 16(8). Gerrish, K. and Lacey, A. (2006). The research process in nursing. 1st ed. Oxford: Blackwell Pub. Gibbins, S. and Stevens, B. (2001). Mechanisms of Sucrose and Non-Nutritive Sucking in Procedural Pain Management in Infants. Pain Research and Management, 6(1), pp.21-28. Guthrie, R., Van Leeuwen, G., Glenn, L. and Jackson, R.L. (1968) The incidence of asymptomatic hypoglycemia in high-risk newborn infants, The Journal of Pediatrics, 72(4), pp. 582-583. doi: 10.1016/s0022-3476(68)80380-4 Hansmann, G. (2009). Neonatal emergencies. 1st ed. Cambridge: Cambridge University Press. Harris, D.L., Weston, P.J. and Harding, J.E. (2012) Incidence of neonatal hypoglycemia in babies identified as at risk, The Journal of Pediatrics, 161(5), pp. 787-791. doi: 10.1016/j.jpeds.2012.05.022. Hay, W., Raju, T., Higgins, R., Kalhan, S. and Devaskar, S. (2009). Knowledge Gaps and Research Needs for Understanding and Treating Neonatal Hypoglycemia: Workshop Report from Eunice Kennedy Shriver National Institute of Child Health and Human Development. The Journal of Pediatrics, 155(5), pp.612-617. Hillman, N., Kallapur, S. and Jobe, A. (2012). Physiology of Transition from Intrauterine to Extrauterine Life. Clinics in Perinatology, 39(4), pp.769-783. Isles, T., Dickson, M. and Farquhar, J. (1968). Glucose Tolerance and Plasma Insulin in Newborn Infants of Normal and Diabetic Mothers. Pediatric Research, 2(3), pp.198-208 Isles, T., Dickson, M. and Farquhar, J. (1968). Glucose Tolerance and Plasma Insulin in Newborn Infants of Normal and Diabetic Mothers. Pediatric Research, 2(3), pp.198-208. Jobe, A. (2015). Transitional neonatal hypoglycemia. The Journal of Pediatrics, 166(6), pp.1329-1332. Johnson AN. The maternal experience of kangaroo holding. J Obstet Gynecol Neonatal Nurs 2007;36(6):568-73. Lang, T. (2014). Neonatal hypoglycemia. Clinical Biochemistry, 47(9), pp.718-719. Liaw, J., Yang, L., Ti, Y., Blackburn, S., Chang, Y. and Sun, L. (2010). Non-nutritive sucking relieves pain for preterm infants during heel stick procedures in Taiwan. Journal of Clinical Nursing, 19(19-20), pp.2741-2751. Lula O.,Lubchenco, M.D, and Harry Bard, M.D (1971) Incidence of hypoglycemia in newborn infants classified by birth weight and gestational age. pediatrics, 47(5), 1971, pp.831-836. Lyon, A. (2004). Applied physiology: temperature control in the newborn infant. Current Paediatrics, 14(2), pp.137-144. Merenstein, G. and Gardner, S. (2011). Merenstein Gardners handbook of neonatal intensive care. 8st ed. St. Louis, Mo.: Mosby Elsevier. Patient- and Family-Centered Care and the Pediatricians Role. (2012). PEDIATRICS, 129(2), pp.394-404. Polin, R., Yoder, M. and Burg, F. (2001). Workbook in practical neonatology. 1st ed. Philadelphia: W.B. Saunders. Polit, D. and Beck, C. (2012). Nursing research. 1st ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams Wilkins. Postnatal Glucose Homeostasis in Late-Preterm and Term Infants. (2011). PEDIATRICS, 127(3), pp.575-579. Rennie, J. and Roberton, N. (2013). Rennie and Robertons textbook of neonatology. 5st ed. Edinburgh: Churchill Livingstone Elsevier. Rozance, P. and Hay, W. (2012). Neonatal Hypoglycemia-Answers, but More Questions. The Journal of Pediatrics, 161(5), pp.775-776. Schwartz, R. and Teramo, K. (2000). Effects of diabetic pregnancy on the fetus and newborn. Seminars in Perinatology, 24(2), pp.120-135. Sparshott, M. (1997). Pain, distress, and the newborn baby. 1st ed. Abingdon, Oxon, OX: Blackwell Science. Staniszewska, S., Brett, J., Redshaw, M., Hamilton, K., Newburn, M., Jones, N. and Taylor, L. (2012). The POPPY Study: Developing a Model of Family-Centred Care for Neonatal Units. Worldviews on Evidence-Based Nursing, 9(4), pp.243-255. Stanley, C., Rozance, P., Thornton, P., De Leon, D., Harris, D., Haymond, M., Hussain, K., Levitsky, L., Murad, M., Simmons, R., Sperling, M., Weinstein, D., White, N. and Wolfsdorf, J. (2015). Re-Evaluating Transitional Neonatal Hypoglycemia: Mechanism and Implications for Management. The Journal of Pediatrics, 166(6), pp.1520-1525.e1. Stomnaroska-Damcevski, O., Petkovska, E., Jancevska, S. and Danilovski, D. (2015). Neonatal Hypoglycemia: A Continuing Debate in Definition and Management. PRILOZI, 36(3). Strozik, K., Pieper, C. and Roller, J. (1997). Capillary refilling time in newborn babies: normal values. Archives of Disease in Childhood Fetal and Neonatal Edition, 76(3), pp.F193-F196. Thornton, P., Stanley, C., De Leon, D., Harris, D., Haymond, M., Hussain, K., Levitsky, L., Murad, M., Rozance, P., Simmons, R., Sperling, M., Weinstein, D., White, N. and Wolfsdorf, J. (2015). Recommendations from the Pediatric Endocrine Society for Evaluation and Management of Persistent Hypoglycemia in Neonates, Infants, and Children. The Journal of Pediatrics, 167(2), pp.238-245. Thureen, P. and Hay, W. (2006). Neonatal nutrition and metabolism. Cambridge, UK: New York. Wielandt, H, Schà ¸nemann-Rigel, H, Holst, C, Fenger-Grà ¸n, J 2015, High risk of neonatal complications in children of mothers with gestational diabetes mellitus in their first pregnancy, Danish Medical Journal, 62, 6, MEDLINE, EBSCOhost, viewed 9 October 2016.

Tombstone AZ :: essays papers

Tombstone AZ "Tombstone has had its share of troublesome people and its high rollers such as the famous Dick Clark. Dick Clark was a trick card man, having an ace up his sleeve or dropping an extra card on the ground for the fun of taking the pot. In 1881 Dick Clark, whose real name was Richard, had run his own saloon in Tombstone. The name of Clacks saloon was 'The Alhambra', with people not being to very good of friends with Clark he had few equals. Clark's saloon was most likely one of the best gambling establishments. Earlier in Mr. Clarks gambling days he had played poker in the army for their money and had enlisted again only to gamble with the army dudes. Tombstone had had some of the best poker games, such as Dick's game against Senator Horace Tabar, and Clark had cleaned him out. Clark had been known for winning as much as 1000 dollars in 6 hands, I believe no one would want to play him when he was on a roll. On his way from coast to coast he was told by a doctor that he had seen that he had an incurable sickness and would later die. The Clark Family, Dick, his wife, and their adopted son had set out from Chicago on their way back to Tombstone. On their way by train they stopped in Albuquerque and Dick died in the hotel in October. When Dicks body was returned to Tombstone, all business closed for his burial."(Time-Life Books, 1978) "Tombstone, Arizona was founded in 1877 and it is the site of the famous gun battle the O.K. Corral. It was said that Tombstone was big for being a place where you could live your life as a king or die with your boots on. Tombstone had become a boomtown a few years later and the silver from mines gave word and it inherited fortune hunters, gamblers, gunfighters, and merchants. This town had, by 1881, a population of 7 thousand and most of which was served by 110 licensed liquor establishments. Because of the way the people are in Tombstone it was a place in which it was hard to raise your kids."(Mike Flanagan, 1987) "Tombstone had a good side to it, the taxing of saloons and others provides the sole support for its school system.

Histology Review Supplement

Histology Review Supplement The slides in this section are designed to provide a basic histology review related to topics introduced in the PhysioEx lab simulations and in your anatomy and physiology textbook. From the PhysioEx main menu, select Histology Tutorial. The opening screen should appear after a few seconds. The Sort by menu is located at the top left. Click on the white drop-down menu and select â€Å"Histology Review† from the list. You will note that the slides in the histology module are grouped in the following folders: Skeletal muscle slides Nervous tissue slides Endocrine tissue slides Cardiovascular tissue slides Respiratory tissue slides Digestive tissue slides Renal tissue slides Select the group of slides you wish to view, and then refer to the relevant worksheet in this section for a step-by-step tutorial. For example, if you would like to review the skeletal muscle slides, click on the Skeletal muscle slides folder, and then turn to the next page of this lab manual for the worksheet entitled Skeletal Muscle Tissue Review to begin your review. You will have the option of viewing slides with or without labels by clicking the On/Off buttons at the bottom left of the viewer. Since the slides in this module have been selected for their relevance to topics covered in the PhysioEx lab simulation, it is recommended that you complete the worksheets along with a related PhysioEx lab. For example, you might complete the Skeletal Muscle Tissue worksheet right before or after your instructor assigns you Exercise 2, the PhysioEx lab simulation on Skeletal Muscle Physiology. For additional histology review, turn to page 121. 23 Skeletal Muscle Tissue Review From the PhysioEx main menu, select Histology Review Supplement. When the screen comes up, click Select an Image Group. From Group Listing, click Skeletal muscle slides. To view slides without labels, click the Labels Off button at the bottom right of the monitor. Click slide 1. Skeletal muscle is composed of extremely large, cylindrical multinucleated cells called myofibers. The nuc lei of the skeletal muscle cell (myonuclei) are located peripherally just subjacent to the muscle cell plasmalemma (sarcolemma). The interior of the cell is literally filled with an assembly of contractile proteins (myofilaments) arranged in a specific overlapping pattern oriented parallel to the long axis of the cell. Click slides 2, 3. Sarcomeres are the functional units of skeletal muscle. The organization of contractile proteins into a regular end-to-end repeating pattern of sarcomeres along the length of each cell accounts for the striated, or striped, appearance of skeletal muscle in longitudinal section. Click slide 4. The smooth endoplasmic reticulum (sarcoplasmic reticulum), modified into an extensive network of membranous channels that store, release, and take up the calcium necessary for contraction, also functions to further organize the myofilaments inside the cell into cylindrical bundles called myofibrils. The stippled appearance of the cytoplasm in cells cut in cross section represents the internal organization of myofilaments bundled into myofibrils by the membranous sarcoplasmic reticulum. What is the functional unit of contraction in skeletal muscle? Click slide 5. The neural stimulus for contraction arises from the axon of a motor neuron whose axon terminal comes into close apposition to the muscle cell sarcolemma. Would you characterize skeletal muscle as voluntary or involuntary? Name the site of close juxtaposition of an axon terminal with the muscle cell plasmalemma. Skeletal muscle also has an extensive connective tissue component that, in addition to conducting blood vessels and nerves, becomes continuous with the connective tissue of its tendon. The tendon in turn is directly continuous with the connective tissue covering (the periosteum) of the adjacent bone. This connective tissue continuity from muscle to tendon to bone is the basis for movement of the musculoskeletal system. What is the name of the loose areolar connective tissue covering of an individual muscle fiber? endomysium The perimysium is a collagenous connective tissue layer that groups several muscle fibers together into bundles called fascicles . the sacromeres What are the two principal contractile proteins that compose the functional unit of contraction? Which connective tissue layer surrounds the entire muscle and merges with the connective tissue of tendons and aponeuroses? epimysium actin and myosin What is the specific relationship of the functional unit of contraction to the striated appearance of a skeletal muscle fiber? the repeating pattern of the sacromeres organized end to end 124 Histology Review Supplement Nervous Tissue Review From the PhysioEx main menu, select Histology Review Supplement. When the screen comes up, click Select an Image Group. From Group Listing, click Nervous tissue slides. To view slides without labels, click the Labels Off button at the bottom right of the monitor. Nervous tissue is composed of nerve cells (neurons) and a variety of support cells. Click slide 1. Each nerve cell consists of a cell body (perikaryon) and one or more cellular processes (axon and dendrites) extending from it. The cell body contains the nucleus, which is typically pale-staining and round or spherical in shape, and the usual assortment of cytoplasmic organelles. Characteristically, the nucleus features a prominent nucleolus often described as resembling the upil of a bird’s eye (â€Å"bird’s eye,† or â€Å"owl’s eye,† nucleolus). Click slide 2. The cytoplasm of the cell body is most often granular in appearance due to the presence of darkly stained clumps of ribosomes and rough endoplasmic reticulum (Nissl bodies/ Nissl substance). Generally, a single axon arises from the cell body at a pale-staining region (axon hillock), devoid of Nissl b odies. The location and number of dendrites arising from the cell body varies greatly. Axons and dendrites are grouped together in the peripheral nervous system (PNS) to form peripheral nerves. What is the primary unit of function in nervous tissue? Click slide 5. Because Schwann cells are aligned in series and myelinate only a small segment of a single axon, small gaps occur between the myelin sheaths of adjacent contiguous Schwann cells. The gaps, called nodes of Ranvier, together with the insulating properties of myelin, enhance the speed of conduction of electrical impulses along the length of the axon. Different support cells and myelinating cells are present in the central nervous system (CNS). What is the general name for all support cells within the CNS? neuroglial cells Name the specific myelinating cell of the CNS. Oligodendrocyte In the PNS, connective tissue also plays a role in providing support and organization. In fact, the composition and organization of the connective tissue investments of peripheral nerves are similar to those of skeletal muscle. Click slide 3. Each individual axon or dendrite is surrounded by a thin and delicate layer of loose connective tissue called the endoneurium (not shown. ) The perineurium, a slightly thicker layer of loose connective tissue, groups many axons and dendrites together into bundles (fascicles). The outermost epineurium surrounds the entire nerve with a thick layer of dense irregular connective tissue, often infiltrated with adipose tissue, that conveys blood and lymphatic vessels to the nerve. There is no connective tissue component within the nervous tissue of the CNS. What is the relationship of the endoneurium to the myelin sheath? neuron Name the pale-staining region of the cell body from which the axon arises. nucleus The support cells of the nervous system perform extremely important functions including support, protection, insulation, and maintenance and regulation of the microenvironment that surrounds the nerve cells. Click slides 3, 4. In the PNS, support cells surround cell bodies (satellite cells) and individual axons and dendrites (Schwann cells). Schwann cells, in particular, are responsible for wrapping their cell membrane jelly-roll style around axons and dendrites to form an insulating sleeve called the myelin sheath. enclosed and protects Histology Review Supplement 125 Endocrine Tissue Review From the PhysioEx main menu, select Histology Review Supplement. When the screen comes up, click Select an Image Group. From Group Listing, click Endocrine tissue slides. To view slides without labels, click the Labels Off button at the bottom right of the monitor. antrum, except for a thin rim of granulosa cells (corona radiata) that encircles the oocyte and a pedestal of granulosa cells (cumulus oophorus) that attaches the oocyte to the inner wall of the antrum. Which cells of the ovarian follicle secrete estrogen? Thyroid Gland The thyroid gland regulates metabolism by regulating the secretion of the hormones T3 (triiodothyronine) and T4 (thyroxine) into the blood. Click slide 1. The gland is composed of fluid-filled (colloid) spheres, called follicles, formed by a simple epithelium that can be squamous to columnar depending upon the gland’s activity. The colloid stored in the follicles is primarily composed of a glycoprotein (thyroglobulin) that is synthesized and secreted by the follicular cells. Under the influence of the pituitary gland, the follicular cells take up the colloid, convert it into T3 and T4, and secrete the T3 and T4 into an extensive capillary network. A second population of cells, parafollicular (C) cells (not shown), may be found scattered through the follicular epithelium but often are present in the connective tissue between follicles. The pale-staining parafollicular cells secrete the protein hormone calcitonin. Why is the thyroid gland considered to be an endocrine organ? Uterus Click slides 4, 5, 6. The uterus is a hollow muscular organ with three major layers: the endometrium, myometrium, and either an adventitia or a serosa. The middle, myometrial layer of the uterine wall is composed of several layers of smooth muscle oriented in different planes. Click slide 6. The innermost (nearest the lumen) endometrial layer is further divided functionally into a superficial functional layer (stratum functionalis) and a deep basal layer (stratum basalis). Click slide 4. A simple columnar epithelium with both ciliated and nonciliated cells lines the surface of the endometrium. The endometrial connective tissue features an abundance of tubular endometrial glands that extend from the base to the surface of the layer. During the proliferative phase of the menstrual cycle, shown here, the endometrium becomes thicker as the glands and blood vessels proliferate. Click slide 5. In the secretory phase, the endometrium and its glands and blood vessels are fully expanded. Click slide 6. In the menstrual phase, the glands and blood vessels degenerate as the functional layer of the endometrium sloughs away. The deep basal layer (stratum basalis) is not sloughed and will regenerate the endometrium during the next proliferative phase. Which layer of the endometrium is shed during the menstrual phase of the menstrual cycle? it secrets a horomone What hormone secreted by the pituitary gland controls the synthesis and secretion of T3 and T4? TSH – thyroid stimulating hormone What is the function of calcitonin? causes CA to be released into blood Ovary The ovary is an organ that serves both an exocrine function in producing eggs (ova) and an endocrine function in secreting the hormones estrogen and progesterone. Click slide 2. Grossly, the ovary is divided into a peripherally located cortex in which the oocytes (precursors to the ovulated egg) develop and a central medulla in which connective tissue surrounds blood vessels, lymphatic vessels and nerves. The oocytes, together with supporting cells (granulosa cells), form the ovarian follicles seen in the cortex at various stages of development. Click slide 3. As an individual oocyte grows, granulosa cells proliferate from a single layer of cuboidal cells that surround the oocyte to a multicellular layer that defines a fluid-filled spherical follicle. In a mature follicle (Graafian follicle), the granulosa cells are displaced to the periphery of the fluid-filled 126 Histology Review Supplement endometrium What is the function of the deep basal layer (stratum basalis) of the endometrium? regenerate new superficial layer What composes a serosa? perimetrium How does the serosa of the uterus, where present, differ from visceral peritoneum? location Pancreas The pancreas is both an endocrine and an exocrine gland. Click slide 7. The exocrine portion is characterized by glandular secretory units (acini) formed by a simple epithelium of triangular or pyramidal cells that encircle a small central lumen. The central lumen is the direct connection to the duct system that conveys the exocrine secretions out of the gland. Scattered among the exocrine secretory units are the pale-staining clusters of cells that compose the endocrine portion of the gland. The cells that form these clusters, called pancreatic islet cells (islets of Langerhans), secrete a number of hormones, including insulin and glucagon. Do the pancreatic islets secrete their hormones into the same duct system used by the exocrine secretory cells? no, but directly into blood stream Histology Review Supplement 127 Cardiovascular Tissue Review From the PhysioEx main menu, select Histology Review Supplement. When the screen comes up, click Select an Image Group. From Group Listing, click Cardiovascular Tissue Slides. To view slides without labels, click the Labels Off button at the bottom right of the monitor. Which component of the intercalated disc is a junction that provides the intercellular communication required for the myocardium to perform as a functional syncytium? gap juntions Blood Vessels Blood vessels form a system of conduits through which lifesustaining blood is conveyed from the heart to all parts of the body and back to the heart again. Click slide 3. Generally, the wall of every vessel is described as being composed of three layers, or tunics. The tunica intima, or tunica interna, a simple squamous endothelium and a small amount of subjacent loose connective tissue, is the innermost layer adjacent to the vessel lumen. Smooth muscle and elastin are the predominant constituents of the middle tunica media, and the outermost tunica adventitia, or tunica externa, is a connective tissue layer of variable thickness that provides support and transmits smaller blood and lymphatic vessels and nerves. The thickness of each tunic varies widely with location and function of the vessel. Arteries, subjected to considerable pressure fluctuations, have thicker walls overall, with the tunica media being thicker than the tunica adventitia. Veins, in contrast, are subjected to much lower pressures and have thinner walls overall, with the tunica adventitia often outsizing the tunica media. Because thin-walled veins conduct blood back to the heart against gravity, valves (not present in arteries) also are present at intervals to prevent backflow. In capillaries, where exchange occurs between the blood and tissues, the tunica intima alone composes the vessel wall. The tunica media of the aorta would have a much greater proportion of what type of tissue than a small artery? Heart The heart is a four-chambered muscular pump. Although its wall can be divided into three distinct histological layers (endocardium, myocardium, and epicardium), the cardiac muscle of the myocardium composes the bulk of the heart wall. Click slide 1. Contractile cardiac muscle cells (myocytes, myofibers) have the same striated appearance as skeletal muscle, but are branched rather than cylindrical in shape and have one (occasionally two) nucleus (myonucleus) rather than many. The cytoplasmic striations represent the same organization of myofilaments (sarcomeres) and alignment of sarcomeres as in skeletal muscle, and the mechanism of contraction is the same. The intercalated disc, however, is a feature unique to cardiac muscle. The densely stained structure is a complex of intercellular junctions (desmosomes, gap junctions, fasciae adherens) that structurally and functionally link cardiac muscle cells end to end. A second population of cells in the myocardium composes the noncontractile intrinsic conduction system (nodal system). Although cardiac muscle is autorhythmic, meaning it has the ability to contract involuntarily in the absence of extrinsic innervation provided by the nervous system, it is the intrinsic conduction system that prescribes the rate and orderly sequence of contraction. Extrinsic innervation only modulates the inherent activity. Click slide 2. Of the various components of the noncontractile intrinsic conduction system, Purkinje fibers are the most readily observed histologically. They are particularly abundant in the ventricular myocardium and are recognized by their very pale-staining cytoplasm and larger diameter. The connective tissue component of cardiac muscle is relatively sparse and lacks the organization present in skeletal muscle. Which component of the intercalated disc is a strong intercellular junction that functions to keep cells from being pulled apart during contraction? lastic fiber In general, which vessel would have a larger lumen, an artery or its corresponding vein? vein Why would the tunica media and tunica adventitia not be present in a capillary? to allow material exchange between blood and tissue desmosomes What is a functional syncytium? Because the cardiac muscle cells are mechanically, chemically, and electrically connecte d to one another, the entire tissue resembles a single, enormous muscle cell. 128 Histology Review Supplement Respiratory Tissue Review From the PhysioEx main menu, select Histology Review Supplement. When the screen comes up, click Select an Image Group. From Group Listing, click Respiratory Tissue Slides. To view slides without labels, click the Labels Off button at the bottom right of the monitor. The respiratory system serves both to conduct oxygenated air deep into the lungs and to exchange oxygen and carbon dioxide between the air and the blood. The trachea, bronchi, and bronchioles are the part of the system of airways that conduct air into the lungs. Click slide 2. The trachea and bronchi are similar in morphology. Their lumens are lined by pseudostratified columnar ciliated epithelium with goblet cells (respiratory epithelium), underlain by a connective tissue lamina propria and a deeper connective tissue submucosa with coiled sero-mucous glands that open onto the surface lining of the airway lumen. Click slide 1. Deep to the submucosa are the hyaline cartilage rings that add structure to the wall of the airway and prevent its collapse. Peripheral to the cartilage is a connective tissue adventitia. The sero-mucous glands are also visible in this slide. Click slide 3. The bronchioles, in contrast, are much smaller in diameter with a continuous layer of smooth muscle in place of the cartilaginous reinforcements. A gradual decrease in the height of the epithelium to simple columnar also occurs as the bronchioles decrease in diameter. Distally the bronchioles give way to the respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli in which gas exchange occurs. In the respiratory bronchiole, the epithelium becomes simple cuboidal and the continuous smooth muscle layer is interrupted at intervals by the presence of alveoli inserted into the bronchiolar wall. Click slide 4. Although some exchange occurs in the respiratory bronchiole, it is within the alveoli of the alveolar ducts and sacs that the preponderance of gas exchange transpires. Here the walls of the alveoli, devoid of smooth muscle, are reduced in thickness to the thinnest possible juxtaposition of simple squamous alveolar cell to simple squamous capillary endothelial cell. What are the primary functions of the respiratory epithelium? What is the primary functional unit of the lung? alveoli The alveolar wall is very delicate and subject to collapse. Why is there no smooth muscle present in its wall for support? smooth muscle would hinder the gas exchange What are the three basic components of the air-blood barrier? alveolar, capillary walls and basal laminae humidfy, filter and warm incoming air Why doesn’t gas exchange occur in bronchi? bronchi have no alveoli Histology Review Supplement 129 Digestive Tissue Review From the PhysioEx main menu, select Histology Review Supplement. When the screen comes up, click Select an Image Group. From Group Listing, click Digestive Tissue Slides. To view slides without labels, click the Labels Off button at the bottom right of the monitor. smooth muscle nearest the stomach, and a mix of both skeletal and smooth muscle in between. 4. The outermost layer of the esophagus is an adventitia for the portion of the esophagus in the thorax, and a serosa after the esophagus penetrates the diaphragm and enters the abdominal cavity. Click slide 3. Here we can see the abrupt change in epithelium at the gastroesophageal junction, where the esophagus becomes continuous with the stomach. Briefly explain the difference between an adventitia and a serosa. Salivary Gland The digestive process begins in the mouth with the physical breakdown of food by mastication. At the same time salivary gland secretions moisten the food and begin to hydrolyze carbohydrates. The saliva that enters the mouth is a mix of serous secretions and mucus (mucin) produced by the three major pairs of salivary glands. Click slide 1. The secretory units of the salivary tissue shown here are composed predominantly of clusters of pale-staining mucussecreting cells. More darkly stained serous cells cluster to form a demilune (half moon) adjacent to the lumen and contribute a clear fluid to the salivary secretion. Salivary secretions flow to the mouth from the respective glands through a well-developed duct system. Are salivary glands endocrine or exocrine glands? serosa secret serous fluid, and adventitia don't. Stomach The wall of the stomach has the same basic four-layered organization as that of the esophagus. Click slide 4. The mucosa of the stomach consists of a simple columnar epithelium, a thin connective tissue lamina propria, and a thin muscularis mucosa. The most significant feature of the stomach mucosa is that the epithelium invaginates deeply into the lamina propria to form superficial gastric pits and deeper gastric glands. Although the epithelium of the stomach is composed of a variety of cell types, each with a unique and important function, only three are mentioned here (see slide 5). Click slide 5. The surface mucous cells are simple columnar cells that line the gastric pits and secrete mucus continuously onto the surface of the epithelium. The large round pink- to red-stained parietal cells that secrete hydrochloric acid (HCl) line the upper half of the gastric glands; more abundant in the lower half of the gastric glands are the chief cells (not shown), usually stained blue, that secrete pepsinogen (a precursor to pepsin). Click slide 4. The submucosa is similar to that of the esophagus but without glands. The muscularis externa has the two typical circumferential and longitudinal layers of smooth muscle, plus an extra layer of smooth muscle oriented obliquely. The stomach’s outermost layer is a serosa. What is the function of the mucus secreted by surface mucous cells? exocrine Which salivary secretion, mucous or serous, is more thin and watery in consistency? serous Esophagus Through contractions of its muscular wall (peristalsis), the esophagus propels food from the mouth to the stomach. Four major layers are apparent when the wall of the esophagus is cut in transverse section: Click slide 2. 1. The mucosa adjacent to the lumen consists of a nonkeratinized stratified squamous epithelium, its immediately subjacent connective tissue (lamina propria) containing blood vessels, nerves, lymphatic vessels, and cells of the immune system, and a thin smooth muscle layer (muscularis mucosa) forms the boundary between the mucosa and the submucosa. Because this slide is a low magnification view, it is not possible to discern all parts of the mucosa nor the boundary between it and the submucosa. 2. The submucosa is a layer of connective tissue of variable density, traversed by larger caliber vessels and nerves, that houses the mucus-secreting esophageal glands whose secretions protect the epithelium and further lubricate the passing food bolus. 3. Much of the substance of the esophageal wall consists of both circumferentially and longitudinally oriented layers of muscle called the muscularis externa. The muscularis externa is composed of skeletal muscle nearest the mouth, 130 Histology Review Supplement protects the epithelium Small Intestine The key to understanding the histology of the small intestine lies in knowing that its major function is absorption. To that end, its absorptive surface area has been amplified greatly in the following ways: 1. The mucosa and submucosa are thrown into permanent folds (plicae circulares). 2. Fingerlike extensions of the lamina propria form villi (singular: villus) that protrude into the intestinal lumen (click slide 7). 3. The individual simple columnar epithelial cells (enterocytes) that cover the villi have microvilli (a brush border), tiny projections of apical plasma membrane to increase their absorptive surface area (click slide 6). Click slide 7. Although all three segments of the small intestine (duodenum, jejunum, and ileum) possess villi and tubular crypts of Lieberkuhn that project deep into the mucosa between villi, some unique features are present in particular segments. For example, large mucous glands (duodenal glands, Brunner’s glands) are present in the submucosa of the duodenum. In addition, permanent aggregates of lymphatic tissue (Peyer’s patches) are a unique characteristic of the ileum (click slide 8). Aside from these specific features and the fact that the height of the villi vary from quite tall in the duodenum to fairly short in the terminal ileum, the overall morphology of mucosa, submucosa, muscularis externa, and serosa is quite similar in all three segments. Why is it important for the duodenum to add large quantities of mucus (from the duodenal glands) to the partially digested food entering it from the stomach? Click slide 10. Located in the surrounding connective tissue, roughly at the points of the hexagon where three lobules meet, is the portal triad (portal canal). Click slide 12. The three constituents of the portal triad include a branch of the hepatic artery, a branch of the hepatic portal vein, and a bile duct. Both the hepatic artery and portal vein empty their oxygen-rich blood and nutrient-rich blood, respectively, into the sinusoids. This blood mixes in the sinusoids and flows centrally in between and around the hepatocytes toward the central vein. Bile, produced by hepatocytes, is secreted into very small channels (bile canaliculi) and flows peripherally (away from the central vein) to the bile duct. Thus, the flow of blood is from peripheral to central in a hepatic lobule, while the bile flow is from central to peripheral. What general type of cell is the phagocytic Kupffer cell? immune Blood in the portal vein flows directly from what organs? liver What is the function of bile in the digestive process? protects intestinal walls raises alkalinity to create ideal pH Colon Click slide 9. The four-layered organization is maintained in the wall of the colon, but the colon has no villi, only crypts of Lieberkuhn. Simple columnar epithelial cells (enterocytes with microvilli) are present to absorb water from the digested food mass, and the numbers of mucous goblet cells are increased substantially, especially toward the distal end of the colon. Why is it important to have an abundance of mucous goblet cells in the colon? because they secrete mucous, which is important to fascilitate degestion Pancreas Click slide 13. The exocrine portion of the pancreas synthesizes and secretes pancreatic enzymes. The individual exocrine secretory unit, or acinus, is formed by a group of pyramidal-shaped pancreatic acinar cells clustered around a central lumen into which they secrete their products. A system of pancreatic ducts then transports the enzymes to the duodenum where they are added to the lumen contents to further aid digestion. The groups of pale-staining cells are the endocrine pancreatic islet (islets of Langerhans) cells. Liver The functional tissue of the liver is organized into hexagonally shaped cylindrical lobules, each delineated by connective tissue. Click slide 11. Within the lobule, large rounded hepatocytes form linear cords that radiate peripherally from the center of the lobule at the central vein to the surrounding connective tissue. Blood sinusoids lined by simple squamous endothelial cells and darkly stained phagocytic Kupffer cells are interposed between cords of hepatocytes in the same radiating pattern. Histology Review Supplement 131 Renal Tissue Review From the PhysioEx main menu, select Histology Review Supplement. When the screen comes up, click Select an Image Group. From Group Listing, click Renal Tissue Slides. To view slides without labels, click the Labels Off button at the bottom right of the monitor. The many functions of the kidney include filtration, absorption, and secretion. The kidney filters the blood of metabolic wastes, water, and electrolytes and reabsorbs most of the water and sodium ions filtered to regulate and maintain the body’s fluid volume and electrolyte balance. The kidney also plays an endocrine role in secreting compounds that increase blood pressure and stimulate red blood cell production. The uriniferous tubule is the functional unit of the kidney. It consists of two components: the nephron to filter and the collecting tubules and ducts to carry away the filtrate. Click slide 1. The nephron itself consists of the renal corpuscle, an intimate association of the glomerular capillaries (glomerulus) with the cup-shaped Bowman’s capsule, and a single elongated renal tubule consisting of segments regionally and sequentially named the proximal convoluted tubule (PCT), the descending and ascending segments of the loop of Henle, and the distal convoluted tubule (DCT). Click slide 2. A closer look at the renal corpuscle shows both the simple squamous epithelium of the outer layer (parietal layer) of the glomerular capsule (Bowman’s capsule) and the specialized inner layer (visceral layer) of podocytes that extend footlike processes to completely envelop the capillaries of the renal glomerulus. Processes of adjacent podocytes interdigitate with one another, leaving only small slits (filtration slits) between the processes through which fluid from the blood is filtered. The filtrate then flows into the urinary space that is directly continuous with the first segment of the renal tubule, the PCT. The PCT is lined by robust cuboidal cells equipped with microvilli to greatly increase the surface area of the side of the cell facing the lumen. Click slide 3. In the loop of Henle, lining cells are simple squamous to simple cuboidal. The DCT cells are also simple cuboidal but are usually much smaller than those of the PCT. The sparse distribution of microvilli, if present at all, on the cells of the DCT relates to their lesser role in absorption. The DCT is continuous directly with the collecting tubules and collecting ducts that drain the filtrate out of the kidney. The large renal artery and its many subdivisions provide an abundant blood supply to the kidney. The smallest distal branches of the renal artery become the afferent arterioles that directly supply the capillaries of the glomerulus. In a unique situation, blood from the glomerular capillaries passes into the efferent arteriole rather than into a venule. The efferent arteriole then perfuses two more capillary beds, the peritubular capillary bed and vasa recta that provide nutrient blood to the kidney tissue itself, before ultimately draining into the renal venous system. In which segment of the renal tubule does roughly 75–80% of reabsorption occur? proximal convoluted tubules How are proximal convoluted tubule (PCT) cells similar to enterocytes of the small intestine? both absorb water, salts, vitamins, phosphates Starting from inside the glomerular capillary through to the urinary space, what are the three layers through which the filtrate must pass? glomerular capillary enothelium, glomrular basement membrane visceral layer of bowman's capsule Under normal circumstances in a healthy individual, would red blood cells or any other cells be present in the renal filtrate? no In addition to providing nutrients to the kidney tubules, what is one other function of the capillaries in the peritubular capillary bed? they deliver blood to tubular sites 132 Histology Review Supplement

The History of the Answering Machine

The History of the Answering Machine According to Adventures in Cybersound, the Danish telephone engineer and inventor Valdemar Poulsen patented what he called a telegraphone in 1898. The telegraphone was the first practical apparatus for magnetic sound recording and reproduction. It was an ingenious apparatus for recording telephone conversations. It recorded, on a wire, the varying magnetic fields produced by a sound. The magnetized wire could then be used to play back the sound. Early Developments Mr. Willy MÃ ¼ller invented the first automatic answering machine in 1935. This answering machine was a three-foot-tall machine popular with Orthodox Jews who were forbidden to answer the phone on the Sabbath. The Ansafone, created by inventor Dr. Kazuo Hashimoto for Phonetel, was the first answering machine sold in the USA, beginning in 1960. Classic Models According to Casio TAD History (Telephone Answering Devices), Casio Communications created the modern telephone answering device (TAD) industry as we know it today by introducing the first commercially viable answering machine a quarter of a century ago. The product- the Model 400- is now featured in the Smithsonian. In 1971, PhoneMate introduced one of the first commercially viable answering machines, the Model 400. The unit weighs 10 pounds, screens calls, and holds 20 messages on a reel-to-reel tape. An earphone enables private message retrieval. Digital Innovation The first digital TAD ​was invented by Dr. Kazuo Hashimoto of Japan in mid-1983. US patent 4,616,110 entitled Automatic Digital Telephone Answering. Voicemail U.S. Patent No. 4,371,752 is the pioneer patent for what evolved into voice mail, and that patent belongs to Gordon Matthews. Gordon Matthews held over thirty-three patents. Gordon Matthews was the founder of the VMX company in Dallas, Texas that produced the first commercial voice mail system, he has become known as the Father of Voice Mail. In 1979, Gordon Matthews formed his company, VMX, of Dallas (Voice Message Express). He applied for a patent in 1979 for his voicemail invention and sold the first system to 3M. When I call a business, I like to talk to a human - Gordon Matthews.

Whats an Excellent ACT Score

What's an Excellent ACT Score SAT / ACT Prep Online Guides and Tips This article would be a pretty short one if there were a singleanswer to the question of what qualifies as an excellent ACT score. Like most things in life, however, what you might consider an excellent score depends on your perspective. In this post, I’ll talk about different ways to understand what counts as excellent test performance. I’ll start off with excellent scores in relation to the general population before discussing more nuanced comparisons: what does it mean to have an excellent score when considering your peer group performance, your target schools, and your own strengths and weaknesses? A Note Before We Get Started: Percentiles Percentiles are the best mathematical way to understand score performance because they help us understand how people perform in relation to each other. Before I talk about excellent ACT scores, I'll give you a (brief) crash course in percentile scores. First, percentile scores are different from percent scores. A percent score tells you what portion of anexam you got correct, whereas percentile score tells you how you did on the exam compared to everyone else who took it. For example,a percent score of 60% means got 60% of the questions right, whereas a percentile score of 60% means you scored better than 60% of the students who took the exam. Percentile scores are more meaningful than percentages when we talk about ACT scores because what’s important is how you score when compared to other students. For example,if you take a difficult test in a large class and only receive a 70%, you might assume you scored poorly. But if everyone else in your class scored lower than a 70%,you would have a 99th percentile score. This information would significantly change the perception of your performance. Now that you have an understanding of percentiles, we can start talking about what it means to have an excellent ACT score. Excellent ACT Scores for the General US Population We're starting with a big crowd and working our way down. It’s hard to get a handle on what ACT scores actually mean without some good, general info about population performance. Who can make intuitive sense out of an exam score without some contextual information? First, you should know that the ACT is scored out of 36 points. The lowest possible composite score is 1.The average national composite score is 21 points. The top 25% of scorers - people with 75th-99th percentile scores- get composite ACT scores of 24 and above. Thebottom 25% of test-takersget composite scores of 16 and below. You may very well have your own ideas about what a reasonable â€Å"excellent score† cutoff should be. For the general population, scores of 24 and above (so, scores that are higher than those of 75% of the population) could reasonably be considered excellent. Here are some other important percentile cutoffs and the corresponding ACT scores for quick reference: 10th percentile composite scores →13-14 25th percentile composite scores→16-17 50th percentile composite scores→21 75th percentile composite scores→24 90th percentile composite scores→28 Excellent ACT Scores for Your Peer Group To get a more nuanced understanding of what an excellent ACT score is, the next step would be to consider the scores of your peers- namely, people in the same geographical area or at the same high school. We’re narrowing down the comparison group here from the entire nation to people who are more similar to you in terms of educational background and opportunities.Here’s how to figure out how to get information on what your peers are scoring: Aggregated High School Information - A school report with ACT score informationshould give you an idea of how your peers tend to score. If you live in a mandatory testing state, you may be able to find this information just by googling "[Your High School Name] ACT score report." If you don’t know where to get this info or if it’s just not available, check in with your guidance counselor to see if shehas insighton the typical ACT score range for your high school. Classmate Information or Word of Mouth - Ifyou can’t get solidinformation on general school performance, you may just want to ask around to see how your peers tend to score. This is a delicate topic, so be respectful and don’t push the subject if someone’s uncomfortable discussing it. Ifyou want a more competitive score range, check in with honor students- they tend to score higher on the ACTs. Once you get information on general school or peerperformance: Consider whether this score distribution matches up with the national average, or if it's higher/lower than expected. If your school/classmates scores are higher/lower than the national average, you can use this info to adjust parametersand expectationsfor your own scores. For example,if most of your peers are scoring above average (21), you might have to score above the national 75th percentile (24) to stand out as â€Å"excellent† among your peers. Excellent ACT Scores for Your Target Colleges We're narrowing in on what's important: excellent ACT scores for the schools you have in your sights. Your ACT score doesn’t have to be perfect (or even necessarily excellent) for you to get into your target schools. They just have to be good enough to get you accepted- after that, they really don’t matter too much.If you have a list of target schools, you can easily figure out what would constitute an excellent ACT score for each particular school. Here’s how to do it: Google â€Å"[name of school] PrepScholar admissions requirements.† On the admissions page, look for the 25th and 75th percentile ACT scores. This will give you an idea of what â€Å"low† (25th percentile) and â€Å"excellent† (75th percentile) ACT scores are for students who attend that particular college. If you want an excellent ACT score for a particular college, aim for that 75thpercentile score. Now, there's some flexibility with this - keep in mind that 75% of students at any college are accepted with scores lower than the 75th percentile cutoff. If your ACT is in the top 25% of scores for schools that you’re considering, you may want to consider applying to some more competitive schools. Schools with higher average ACT scorestend to have more ambitiousstudents and more challenging courses. A high-ranking school also sends a better signal to grad schools and employers. Ultimately, it's a good strategy to apply to several target, reach, and safety schools- knowing schools' ACT score ranges will help you figure out which ones will best fit within this strategy. Excellent ACT Scores for Yourself This is perhaps the most important consideration with the most practical implications. Given your goals, strengths, and weaknesses, what’s considered an excellent ACT score for you personally? There are quite a few factors to take into account here: Whether you're a â€Å"good† test-taker or ananxious test-taker Your innate skill setfor each ACT section Your educational opportunities- some students may not have a strong background in all ACT content Your resources- some students may have access to prep courses, tutors, or extra help, whereas others may not It’s important to set a realistic but challenging goal in order to meet your full potential. If you set too low of a goal, you cheat yourself out of the opportunity to attend better colleges. If you settoo high of a goal, you may feel unnecessarilydemotivated and frustrated. So where do you begin figuring out what an excellent ACT score means for you? Here's how to do it: Get a baseline score. Take a practice test after familiarizing yourself with the ACT for about 10 hours of prep. You might consider this baseline your low score cutoff- after all, you did get this score with pretty minimal study time. Reach your own score potential. Know that whatever you scored on your baseline, there will be significant room for improvement with good prep. Many students reach a score max (an excellent personalscore) after about 40-80 hours of studying. This score maximum is generally 3-4 points higher than baseline, although it's definitely possible to increase your score more than that. How Do You Get an Excellent ACT Score? Now comes the real work: getting the scores that you want! There are three key components to earning an excellent score, however you define it: a solid timeline, a concrete goal, and a smart study plan. Timeline The amount of time you have to prep will directly affect your study timeline. Read our guide on how long you should study for the ACT. Goal Score Work towards a concrete goal after making a list of target, reach, and safety schools. Get instructions on how to set a goal score in our ACT score guide. Want a beyond-excellent ACT score? We have a guide for that too. Study Plan Now that you have a study timeline and goal score in place, you'll need a smart study plan. This plan will, of course, depend on when you're taking the test. Don't have a lot of time? Read our last-minute tipsand strategies, or our 10-day study plan. Have a bit more time on your hands? Read our study schedule for students who have one year or more to prepare. What's Next? If you're still deciding whether to take the SAT or the ACT, you might be wondering which one will get you the best scores. Read more about how to decide which test is the best fit for you. Looking for more info on the SAT? Read about what counts as anexcellent or bad SAT score. Disappointed with your ACT scores? Want to improve your ACT score by 4+ points? Download our free guide to the top 5 strategies you need in your prep to improve your ACT score dramatically.

How To Become A Pop Star essays

How To Become A Pop Star essays Pop music is incredibly popular. Not only can one hear bands such as the Backstreet Boys or 'N Sync playing on just about every radio station in the country, but bands such as this can be seen in toy stores in the form of "action figures," or on posters hanging on the bedroom walls of pre-pubescent girls nationwide. These pretty faces and high-pitched voices are enough to drive the average, red-blooded male up the wall and beg for the days of Led Zeppelin and ZZ Top. Despite the disdain showed by the average male towards these "talented musicians," one must give them credit for earning infinitely more money in their few short years of fame than one usually earns over the course of a lifetime. Since this is true, everyone should be allowed to know what exactly it takes to become a pop star. By carefully examining three important requirements of pop-stardom, one could easily become a pop star themselves. As unorthodox as some of these requirements may seem, they are all being fulfille d by the pop stars of today and are surely keys to instant success. If one wishes to become a pop star, the first requirement is a change in wardrobe. Simply by watching an award show such as the MTV Music Awards or the Teen Choice Awards, one can see just what type of digs it takes to make it in the world of pop-stardom. The key to popstar dress is the outlandishness of the outfit. Take AJ from the Backstreet Boys for example. You will never see this "guy" wearing a shirt with arms on it. Since he has a plethora of tattoos on both of his arms, he finds it necessary to show off his twig-like arms wherever he goes. To compliment his armless shirts, AJ chooses a large, novelty cowboy hat that would surely cripple the neck of a normal human being because of its size. However, since AJ and his "band" have been wildly successful, aspiring pop stars should hurry out to their local clothing boutiques and purchase the most ridiculous looking outfits they can f...