Saturday, September 14, 2019
Discourage people from damaging their own health Essay
What more should be done to discourage people from damaging their own health? Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Discouraging people from damaging their own health is important because it will help the people to live a healthy lifestyle and with a healthy lifestyle, the people can live longer without any health problems or diseases. There are many ways to discourage people from damaging their own health, especially such as discouraging the people from smoking. To discourage people from smoking it can be done by putting tobacco labels, stop advertising, raising taxes and banning smoking. Tobacco labels are like warning messages that appear on the packaging of cigarettes and other tobacco products concerning the health effects of those products. There have been implemented in an effort to enhance the publicââ¬â¢s awareness of the harmful effects of smoking. For example, in the United States, on September 2012, all cigarettes for sale or distributed in the United States were to be packaged or advertised with these new cigarette health and a stop smoking hotline number. Studies have shown that viewers had a stronger response to the pictures than to written warnings. Cigarettes advertisements that are carried on televisions, radios and internet websites, should be stopped. If it is not being put to a halt, the people will smoke more and damage their own health more. Instead they should advertise the side effects of smoking too much cigarettes. For example, in the United States, the congress banned cigarette advertising on TV and radio in 1971 and spit tobacco advertising in 1987. The American Legacy Foundation and many states have made anti-smoking public service messages that are featured on television, radio, and billboards. Some tobacco companies have come up with their own advertisements, which appear to be anti-smoking and it actually helps reduce the amount of smokers. Raising the taxes of cigarettes, will reduce the amount of people or may be even stop them from smoking therefore the people will be able to live healthy a lifestyle. An example is in the U.S. The taxes on cigarettes have risen in many states in recent years. These increased costs have been shown to discourage young people from starting to smoke and encourage smokers to quit. As of early 2014, the federal cigarette tax is $1.01 per pack. State taxes on tobacco vary from as low as 17 cents in Missouri to upà to $4.35 a pack in New York. Nearly all states and Washington DC levy their own taxes on other tobacco products such as cigars, pipe tobacco, snuff, and chewing tobacco. As of 2014, Pennsylvania charges no state tax on non-cigarette tobacco products, while Minnesota and Washington both charge 95% of the wholesale price of the tobacco product in taxes. The most important way to stop people from smoking is by banning smoking in some countries. This means that the government will introduce the law into the country and if anyone who goes against the law, will have to pay a fine. In the United States, the laws in all 50 states and the District of Columbia restrict or do not allow smoking in certain public places. These laws range from simple restrictions, such as designated areas in state or local government buildings, to laws that ban smoking in all public places and workplaces. Federal buildings are required to be smoke-free. Smoking is also banned on all domestic airplane flights. According to the US Surgeon General, smoke-free policies that ban smoking in all indoor areas are the only way to be sure that people are not exposed to secondhand smoke at work and in other public places. In my conclusion, I think the government or any organizations should be raise more awareness of the side effects of smoking cigarettes by organizing exhibitions, making leaflets about the side effects of smoking and televisions advertisements to raise awareness. From there, the people would understand the bad effects of smoking too much cigarettes.
Friday, September 13, 2019
Blood pressure Essay Example for Free (#2)
Blood pressure Essay Blood pressure (BP), sometimes referred to as arterial blood pressure, is the pressureexerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. When used without further specification, ââ¬Å"blood pressureâ⬠usually refers to thearterial pressure of the systemic circulation. During each heartbeat, blood pressure varies between a maximum (systolic) and a minimum (diastolic) pressure.[1] The blood pressure in the circulation is principally due to the pumping action of the heart.[2] Differences in mean blood pressure are responsible for blood flow from one location to another in the circulation. The rate of mean blood flow depends on the resistance to flow presented by the blood vessels. Mean blood pressure decreases as the circulating blood moves away from the heart through arteries and capillaries due to viscous losses of energy. Mean blood pressure drops over the whole circulation, although most of the fall occurs along the small arteries and arterioles.[3] Gravity affects blood pressure via hydrostatic forces (e.g., during standing) and valves in veins, breathing, and pumping from contraction of skeletal muscles also influence blood pressure in veins.[2] The measurement blood pressure without further specification usually refers to the systemic arterial pressure measured at a personââ¬â¢s upper arm and is a measure of the pressure in the brachial artery, major artery in the upper arm. A personââ¬â¢s blood pressure is usually expressed in terms of the systolic pressure over diastolic pressure and is measured in millimetres of mercury (mmHg), for example 120/80. The table on the right shows the classification of blood pressure adopted by the American Heart Association for adults who are 18 years and older.[4] It assumes the values are a result of averaging blood pressure readings measured at two or more visits to the doctor.[6][7] In the UK, blood pressures are usually categorised into three groups: low (90/60 or lower), high (140/90 or higher), and normal (values above 90/60 and below 130/80).[8][9] While average values for arterial pressure could be computed for any given population, there is often a large variation from person to person; arterial pressure also varies in individuals from moment to moment. Additionally, the average of any given population may have a questionable correlation with its general health; thus the relevance of such average values is equally questionable. However, in a study of 100 human subjects with no known history of hypertension, an average blood pressure of 112/64 mmHg was found,[10] which are currently classified as desirable or ââ¬Å"normalâ⬠values. Normal values fluctuate through the 24-hour cycle, with highest readings in the afternoons and lowest readings at night.[11][12] Various factors, such as age and sex influence average values, influence a personââ¬â¢s average blood pressure and variations. In children, the normal ranges are lower than for adults and depend on height.[13] As adults age, systolic pressure tends to rise and diastolic tends to fall.[14] In the elderly, blood pressure tends to be above the normal adult range,[15] largely because of reduced flexibility of the arteries. Also, an individualââ¬â¢s blood pressure varies with exercise, emotional reactions, sleep, digestion and time of day. Differences between left and right arm blood pressure measurements tend to be random and average to nearly zero if enough measurements are taken. However, in a small percentage of cases there is a consistent difference greater than 10 mmHg which may need further investigation, e.g. for obstructive arterial disease.[16][17] The risk of cardiovascular disease increases progressively above 115/75 mmHg.[18] In the past, hypertension was only diagnosed if secondary signs of high arterial pressure were present, along with a prolonged high systolic pressure reading over several visits. Regarding hypotension, in practice blood pressure is considered too low only if noticeable symptoms are present.[5] Clinical trials demonstrate that people who maintain arterial pressures at the low end of these pressure ranges have much better long term cardiovascular health. The principal medical debate concerns the aggressiveness and relative value of methods used to lower pressures into this range for those who do not maintain such pressure on their own. Elevations, more commonly seen in older people, though often considered normal, are associated with increased morbidity and mortality. There are many physical factors that influence arterial pressure. Each of these may in turn be influenced by physiological factors, such as diet, exercise, disease, drugs or alcohol, stress, obesity, and so-forth.[20] â⬠¢ Volume of fluid or blood volume, the amount of blood that is present in the body. The more blood present in the body, the higher the rate of blood return to the heart and the resulting cardiac output. There is some relationship between dietary salt intake and increased blood volume, potentially resulting in higher arterial pressure, though this varies with the individual and is highly dependent on autonomic nervous system response and the renin-angiotensin system.[21][22][23] â⬠¢ Resistance. In the circulatory system, this is the resistance of the blood vessels. The higher the resistance, the higher the arterial pressure upstream from the resistance to blood flow. Resistance is related to vessel radius (the larger the radius, the lower the resistance), vessel length (the longer the vessel, the higher the resistance), blood viscosity, as well as the smoothness of the blood vessel walls. Smoothness is reduced by the build up of fatty deposits on the arterial walls. Substances called vasoconstrictors can reduce the size of blood vessels, thereby increasing blood pressure. Vasodilators (such as nitroglycerin) increase the size of blood vessels, thereby decreasing arterial pressure. Resistance, and its relation to volumetric flow rate (Q) and pressure difference between the two ends of a vessel are described by Poiseuilleââ¬â¢s Law. â⬠¢ Viscosity, or thickness of the fluid. If the blood gets thicker, the result is an increase in arterial pressure. Certain medical conditionscan change the viscosity of the blood. For instance, anemia (low red blood cell concentration), reduces viscosity, whereas increased red blood cell concentration increases viscosity. It had been thought that aspirin and related ââ¬Å"blood thinnerâ⬠drugs decreased the viscosity of blood, but instead studies found[24] that they act by reducing the tendency of the blood to clot. In practice, each individualââ¬â¢s autonomic nervous system responds to and regulates all these interacting factors so that, although the above issues are important, the actual arterial pressure response of a given individual varies widely because of both split-second and slow-moving responses of the nervous system and end organs. These responses are very effective in changing the variables and resulting blood pressure from moment to moment. Moreover, blood pressure is the result of cardiac output increased by peripheral resistance: blood pressure = cardiac output Xperipheral resistance. As a result, an abnormal change in blood pressure is often an indication of a problem affecting the heartââ¬â¢s output, the blood vesselsââ¬â¢ resistance, or both. Thus, knowing the patientââ¬â¢s blood pressure is critical to assess any pathology related to output and resistance. The mean arterial pressure (MAP) is the average over a cardiac cycle and is determined by the cardiac output (CO), systemic vascular resistance (SVR), and central venous pressure (CVP),[25] Curve of the arterial pressure during one cardiac cycle The up and down fluctuation of the arterial pressure results from the pulsatile nature of thecardiac output, i.e. the heartbeat. The pulse pressure is determined by the interaction of thestroke volume of the heart, compliance (ability to expand) of the aorta, and the resistance to flow in the arterial tree. By expanding under pressure, the aorta absorbs some of the force of the blood surge from the heart during a heartbeat. In this way, the pulse pressure is reduced from what it would be if the aorta wasnââ¬â¢t compliant.[26] The loss of arterial compliance that occurs with aging explains the elevated pulse pressures found in elderly patients. The pulse pressure can be simply calculated from the difference of the measured systolic and diastolic pressures,[26] The armââ¬âleg (blood pressure) gradient is the difference between the blood pressure measured in the arms and that measured in the legs. It is normally less than 10 mmHg,[27] but may be increased in e.g. coarctation of the aorta.[27] The larger arteries, including all large enough to see without magnification, are conduits with low vascular resistance (assuming no advanced atherosclerotic changes) with high flow rates that generate only small drops in pressure. The smaller arteries and arterioles have higher resistance, and confer the main drop in blood pressure along the circulatory system. Modern physiology developed the concept of the vascular pressure wave (VPW). This wave is created by the heart during the systoleand originates in the ascending aorta. Much faster than the stream of blood itself, it is then transported through the vessel walls to the peripheral arteries. There the pressure wave can be palpated as the peripheral pulse. As the wave is reflected at the peripheral veins, it runs back in a centripetal fashion. When the reflected wave meets the next outbound pressure wave, the pressure inside the vessel rises higher than the pressure in the aorta. This concept explains why the arterial pressure inside the peripheral arteries of the legs and arms is higher than the arterial pressure in the aorta,[28][29][30] and in turn for the higher pressures seen at the ankle compared to the arm with normal ankle brachial pressure index values. The endogenous regulation of arterial pressure is not completely understood, but the following mechanisms of regulating arterial pressure have been well-characterized: â⬠¢ Baroreceptor reflex: Baroreceptors in the high pressure receptor zones detect changes in arterial pressure. These baroreceptors send signals ultimately to the medulla of the brain stem, specifically to the Rostral ventrolateral medulla (RVLM). The medulla, by way of the autonomic nervous system, adjusts the mean arterial pressure by altering both the force and speed of the heartââ¬â¢s contractions, as well as the total peripheral resistance. The most important arterial baroreceptors are located in the left and rightcarotid sinuses and in the aortic arch.[31] â⬠¢ Renin-angiotensin system (RAS): This system is generally known for its long-term adjustment of arterial pressure. This system allows the kidney to compensate for loss in blood volume or drops in arterial pressure by activating an endogenous vasoconstrictorknown as angiotensin II. â⬠¢ Aldosterone release: This steroid hormone is released from the adrenal cortex in response to angiotensin II or high serum potassiumlevels. Aldosterone stimulates sodium retention and potassium excretion by the kidneys. Since sodium is the main ion that determines the amount of fluid in the blood vessels by osmosis, aldosterone will increase fluid retention, and indirectly, arterial pressure. â⬠¢ Baroreceptors in low pressure receptor zones (mainly in the venae cavae and the pulmonary veins, and in the atria) result in feedback by regulating the secretion of antidiuretic hormone (ADH/Vasopressin), renin and aldosterone. The resultant increase inblood volume results an increased cardiac output by the Frankââ¬âStarling law of the heart, in turn increasing arterial blood pressure. These different mechanisms are not necessarily independent of each other, as indicated by the link between the RAS and aldosterone release. Currently, the RAS is targeted pharmacologically by ACE inhibitors and angiotensin II receptor antagonists. The aldosterone system is directly targeted by spironolactone, an aldosterone antagonist. The fluid retention may be targeted by diuretics; the antihypertensive effect of diuretics is due to its effect on blood volume. Generally, the baroreceptor reflex is not targeted in hypertensionbecause if blocked, individuals may suffer from orthostatic hypotension and fainting. A medical student checking blood pressure using a sphygmomanometer and stethoscope. Arterial pressure is most commonly measured via a sphygmomanometer, which historically used the height of a column of mercury to reflect the circulating pressure.[32] Blood pressure values are generally reported in millimetres of mercury (mmHg), though aneroid and electronic devices do not use mercury. For each heartbeat, blood pressure varies between systolic and diastolic pressures. Systolic pressure is peak pressure in the arteries, which occurs near the end of the cardiac cyclewhen the ventricles are contracting. Diastolic pressure is minimum pressure in the arteries, which occurs near the beginning of the cardiac cycle when the ventricles are filled with blood. An example of normal measured values for a resting, healthy adult human is 120 mmHgsystolic and 80 mmHg diastolic (written as 120/80 mmHg, and spoken [in the US and UK] as ââ¬Å"one-twenty over eightyâ⬠). Systolic and diastolic arterial blood pressures are not static but undergo natural variations from one heartbeat to another and throughout the day (in a circadian rhythm). They also change in response to stress, nutritional factors, drugs, disease, exercise, and momentarily from standing up. Sometimes the variations are large. Hypertension refers to arterial pressure being abnormally high, as opposed to hypotension, when it is abnormally low. Along with body temperature, respiratory rate, and pulse rate, blood pressure is one of the four main vital signs routinely monitored by medical professionals and healthcare providers.[33] Measuring pressure invasively, by penetrating the arterial wall to take the measurement, is much less common and usually restricted to a hospital setting. The noninvasive auscultatory and oscillometric measurements are simpler and quicker than invasive measurements, require less expertise, have virtually no complications, are less unpleasant and less painful for the patient. However, noninvasive methods may yield somewhat lower accuracy and small systematic differences in numerical results. Noninvasive measurement methods are more commonly used for routine examinations and monitoring. A minimum systolic value can be roughly estimated by palpation, most often used in emergency situations, but should be used with caution.[34] It has been estimated that, using 50% percentiles, carotid, femoral and radial pulses are present in patients with a systolic blood pressure > 70 mmHg, carotid and femoral pulses alone in patients with systolic blood pressure of > 50 mmHg, and only a carotid pulse in patients with a systolic blood pressure of > 40 mmHg.[34] A more accurate value of systolic blood pressure can be obtained with a sphygmomanometer and palpating the radial pulse.[35] The diastolic blood pressure cannot be estimated by this method.[36] The American Heart Association recommends that palpation be used to get an estimate before using the auscultatory method. Auscultatory method aneroid sphygmomanometer with stethoscope Mercury manometer The auscultatory method (from the Latin word for ââ¬Å"listeningâ⬠) uses a stethoscope and asphygmomanometer. This comprises an inflatable (Riva-Rocci) cuff placed around the upperarm at roughly the same vertical height as the heart, attached to a mercury or aneroidmanometer. The mercury manometer, considered the gold standard, measures the height of a column of mercury, giving an absolute result without need for calibration and, consequently, not subject to the errors and drift of calibration which affect other methods. The use of mercury manometers is often required in clinical trials and for the clinical measurement of hypertension in high-risk patients, such as pregnant women. A cuff of appropriate size is fitted smoothly and snugly, then inflated manually by repeatedly squeezing a rubber bulb until the artery is completely occluded. Listening with the stethoscope to the brachial artery at the elbow, the examiner slowly releases the pressure in the cuff. When blood just starts to flow in the artery, the turbulent flow creates a ââ¬Å"whooshingâ⬠or pounding (first Korotkoff sound). The pressure at which this sound is first heard is the systolic blood pressure. The cuff pressure is further released until no sound can be heard (fifth Korotkoff sound), at the diastolic arterial pressure. The auscultatory method is the predominant method of clinical measurement.[37] The oscillometric method was first demonstrated in 1876 and involves the observation of oscillations in the sphygmomanometer cuff pressure[38] which are caused by the oscillations of blood flow, i.e., the pulse.[39] The electronic version of this method is sometimes used in long-term measurements and general practice. It uses a sphygmomanometer cuff, like the auscultatory method, but with an electronic pressure sensor (transducer) to observe cuff pressure oscillations, electronics to automatically interpret them, and automatic inflation and deflation of the cuff. The pressure sensor should be calibrated periodically to maintain accuracy. Oscillometric measurement requires less skill than the auscultatory technique and may be suitable for use by untrained staff and for automated patient home monitoring. The cuff is inflated to a pressure initially in excess of the systolic arterial pressure and then reduced to below diastolic pressure over a period of about 30 seconds. When blood flow is nil (cuff pressure exceeding systolic pressure) or unimpeded (cuff pressure below diastolic pressure), cuff pressure will be essentially constant. It is essential that the cuff size is correct: undersized cuffs may yield too high a pressure; oversized cuffs yield too low a pressure. When blood flow is present, but restricted, the cuff pressure, which is monitored by the pressure sensor, will vary periodically in synchrony with the cyclic expansion and contraction of the brachial artery, i.e., it will oscillate. The values of systolic and diastolic pressure are computed, not actually measured from the raw data, using an algorithm; the computed results are displayed. Oscillometric monitors may produce inaccurate readings in patients with heart and circulation problems, which include arterial sclerosis, arrhythmia, preeclampsia, pulsus alternans, and pulsus paradoxus. In practice the different methods do not give identical results; an algorithm and experimentally obtained coefficients are used to adjust the oscillometric results to give readings which match the auscultatory results as well as possible. Some equipment uses computer-aided analysis of the instantaneous arterial pressure waveform to determine the systolic, mean, and diastolic points. Since many oscillometric devices have not been validated, caution must be given as most are not suitable in clinical and acute care settings. The term NIBP, for non-invasive blood pressure, is often used to describe oscillometric monitoring equipment. Continuous noninvasive techniques (CNAP) Continuous Noninvasive Arterial Pressure (CNAP) is the method of measuring arterial blood pressure in real-time without any interruptions and without cannulating the human body. CNAP combines the advantages of the following two clinical ââ¬Å"gold standardsâ⬠: it measures blood pressure continuously in real-time like the invasive arterial catheter system and it is noninvasive like the standard upper arm sphygmomanometer. Latest developments in this field show promising results in terms of accuracy, ease of use and clinical acceptance. Non-occlusive techniques: the Pulse Wave Velocity (PWV) principle Since the 90s a novel family of techniques based on the so-called Pulse wave velocity (PWV) principle have been developed. These techniques rely on the fact that the velocity at which an arterial pressure pulse travels along the arterial tree depends, among others, on the underlying blood pressure.[40] Accordingly, after a calibration maneuver, these techniques provide indirect estimates of blood pressure by translating PWV values into blood pressure values.[41] The main advantage of these techniques is that it is possible to measure PWV values of a subject continuously (beat-by-beat), without medical supervision, and without the need of inflating brachial cuffs. PWV-based techniques are still in the research domain and are not adapted to clinical settings. For some patients, blood pressure measurements taken in a doctorââ¬â¢s office may not correctly characterize their typical blood pressure.[42] In up to 25% of patients, the office measurement is higher than their typical blood pressure. This type of error is calledwhite-coat hypertension (WCH) and can result from anxiety related to an examination by a health care professional.[43] The misdiagnosis of hypertension for these patients can result in needless and possibly harmful medication. WCH can be reduced (but not eliminated) with automated blood pressure measurements over 15 to 20 minutes in a quiet part of the office or clinic.[44] Debate continues regarding the significance of this effect.[citation needed] Some reactive patients will react to many other stimuli throughout their daily lives and require treatment. In some cases a lower blood pressure reading occurs at the doctorââ¬â¢s office.[45] Ambulatory blood pressure devices that take readings every half hour throughout the day and night have been used for identifying and mitigating measurement problems like white-coat hypertension. Except for sleep, home monitoring could be used for these purposes instead of ambulatory blood pressure monitoring.[46] Home monitoring may be used to improve hypertension management and to monitor the effects of lifestyle changes and medication related to blood pressure.[6] Compared to ambulatory blood pressure measurements, home monitoring has been found to be an effective and lower cost alternative,[46][47][48] but ambulatory monitoring is more accurate than both clinic and home monitoring in diagnosing hypertension. Ambulatory monitoring is recommended for most patients before the start of antihypertensive drugs.[49] Aside from the white-coat effect, blood pressure readings outside of a clinical setting are usually slightly lower in the majority of people. The studies that looked into the risks from hypertension and the benefits of lowering blood pressure in affected patients were based on readings in a clinical environment. When measuring blood pressure, an accurate reading requires that one not drink coffee, smoke cigarettes, or engage in strenuous exercise for 30 minutes before taking the reading. A full bladder may have a small effect on blood pressure readings; if the urge to urinate arises, one should do so before the reading. For 5 minutes before the reading, one should sit upright in a chair with oneââ¬â¢s feet flat on the floor and with limbs uncrossed. The blood pressure cuff should always be against bare skin, as readings taken over a shirt sleeve are less accurate. During the reading, the arm that is used should be relaxed and kept at heart level, for example by resting it on a table.[50] Since blood pressure varies throughout the day, measurements intended to monitor changes over longer time frames should be taken at the same time of day to ensure that the readings are comparable. Suitable times are: â⬠¢ immediately after awakening (before washing/dressing and taking breakfast/drink), while the body is still resting, â⬠¢ immediately after finishing work. Automatic self-contained blood pressure monitors are available at reasonable prices, some of which are capable of Korotkoffââ¬â¢s measurement in addition to oscillometric methods, enabling irregular heartbeat patients to accurately measure their blood pressure at home. Arterial blood pressure (BP) is most accurately measured invasively through an arterial line. Invasive arterial pressure measurement with intravascular cannulae involves direct measurement of arterial pressure by placing a cannula needle in an artery (usually radial, femoral,dorsalis pedis or brachial). The cannula must be connected to a sterile, fluid-filled system, which is connected to an electronic pressure transducer. The advantage of this system is that pressure is constantly monitored beat-by-beat, and a waveform (a graph of pressure against time) can be displayed. This invasive technique is regularly employed in human and veterinary intensive care medicine, anesthesiology, and for research purposes. Cannulation for invasive vascular pressure monitoring is infrequently associated with complications such as thrombosis, infection, andbleeding. Patients with invasive arterial monitoring require very close supervision, as there is a danger of severe bleeding if the line becomes disconnected. It is generally reserved for patients where rapid variations in arterial pressure are anticipated. Invasive vascular pressure monitors are pressure monitoring systems designed to acquire pressure information for display and processing. There are a variety of invasive vascular pressure monitors for trauma, critical care, and operating room applications. These include single pressure, dual pressure, and multi-parameter (i.e. pressure / temperature). The monitors can be used for measurement and follow-up of arterial, central venous, pulmonary arterial, left atrial, right atrial, femoral arterial, umbilical venous, umbilical arterial, and intracranial pressures. Further information: Fetal circulation#Blood pressure In pregnancy, it is the fetal heart and not the motherââ¬â¢s heart that builds up the fetal blood pressure to drive its blood through the fetal circulation. The blood pressure in the fetal aorta is approximately 30 mmHg at 20 weeks of gestation, and increases to approximately 45 mmHg at 40 weeks of gestation.[51] The average blood pressure for full-term infants: Systolic 65ââ¬â95 mm Hg Diastolic 30ââ¬â60 mm Hg[52] Blood pressure is the measurement of force that is applied to the walls of the blood vessels as the heart pumps blood throughout the body.[53] The human circulatory system is 400,000 miles long, and the magnitude of blood pressure is not uniform in all the blood vessels in the human body. The blood pressure is determined by the diameter, flexibility and the amount of blood being pumped through the blood vessel.[53] Blood pressure is also affected by other factors including exercise, stress level, diet and sleep. The average normal blood pressure in the brachial artery, which is the next direct artery from the aorta after the subclavian artery, is 120mmHg/80mmHg. Blood pressure readings are measured in millimeters of mercury (mmHg) using sphygmomanometer. Two pressures are measured and recorded namely as systolic and diastolic pressures. Systolic pressure reading is the first reading, which represents the maximum exerted pressure on the vessels when the heart contracts, while the diastolic pressure, the second reading, represents the minimum pressure in the vessels when the heart relaxes.[54] Other major arteries have similar levels of blood pressure recordings indicating very low disparities among major arteries. The innominate artery, the average reading is 110/70mmHg, the right subclavian artery averages 120/80 and the abdominal aorta is 110/70mmHg.[55] The relatively uniform pressure in the arteries indicate that these blood vessels act as a pressure reservoir for fluids that are transported within them. Pressure drops gradually as blood flows from the major arteries, through the arterioles, the capillaries until blood is pushed up back into the heart via the venules, the veins through the vena cava with the help of the muscles. At any given pressure drop, the flow rate is determined by the resistance to the blood flow. In the arteries, with the absence of diseases, there is very little or no resistance to blood. The vessel diameter is the most principal determinant to control resistance. Compared to other smaller vessels in the body, the artery has a much bigger diameter (4mm), therefore the resistance is low.[55] In addition, flow rate (Q) is also the product of the cross-sectional area of the vessel and the average velocity (Q = AV). Flow rate is directly proportional to the pressure drop in a tube or in this case a vessel. âËâ P à ± Q. The relationship is further described by Poisseulleââ¬â¢s equation âËâ P = 8à µlQ/Ãâ¬r4.[56] As evident in the Poisseulleââ¬â¢s equation, although flow rate is proportional to the pressure drop, there are other factors of blood vessels that contribute towards the difference in pressure drop in bifurcations of blood vessels. These include viscosity, length of the vessel, and radius of the vessel. Factors that determine the flowââ¬â¢s resistance as described by Poiseuilleââ¬â¢s relationship: â⬠¢ âËâ P: pressure drop/gradient â⬠¢ à µ: viscosity â⬠¢ l: length of tube. In the case of vessels with infinitely long lengths, l is replaced with diameter of the vessel. â⬠¢ Q: flow rate of the blood in the vessel â⬠¢ r: radius of the vessel Assuming steady, laminar flow in the vessel, the blood vessels behavior is similar to that of a pipe. For instance if p1 and p2 are pressures are at the ends of the tube, the pressure drop/gradient is:[57] In the arterioles blood pressure is lower than in the major arteries. This is due to bifurcations, which cause a drop in pressure. The more bifurcations, the higher the total cross-sectional area, therefore the pressure across the surface drops. This is why the arterioles have the highest pressure-drop. The pressure drop of the arterioles is the product of flow rate and resistance: âËâ P=Q xresistance. The high resistance observed in the arterioles, which factor largely in the âËâ P is a result of a smaller radius of about 30 à µm.[58] The smaller the radius of a tube, the larger the resistance to fluid flow. Immediately following the arterioles are the capillaries. Following the logic obvserved in the arterioles, we expect the blood pressure to be lower in the capillaries compared to the arterioles. Since pressure is a function of force per unit area, (P = F/A), the larger the surface area, the lesser the pressure when an external force acts on it. Though the radii of the capillaries are very small, the network of capillaries have the largest surface area in the vascular network. They are known to have the largest surface area (485mm) in the human vascular network. The larger the total cross-sectional area, the lower the mean velocity as well as the pressure.[55] Reynoldââ¬â¢s number also affects the blood flow in capillaries. Due to its smaller radius and lowest velocity compared to other vessels, the Reynoldââ¬â¢s number at the capillaries is very low, resulting in laminar instead of turbulent flow.[59] The Reynoldââ¬â¢s number (denoted NR or Re) is a relationship that helps determine the behavior of a fluid in a tube, in this case blood in the vessel. The equation for this dimensionless relationship is written as:[56] â⬠¢ à : density of the blood â⬠¢ v: mean velocity of the blood â⬠¢ L: characteristic dimension of the vessel, in this case diameter â⬠¢ à ¼: viscosity of blood The Reynoldââ¬â¢s number is directly proportional to the velocity and diameter of the tube. Note that NR is directly proportional to the mean velocity as well as the diameter. A Reynoldââ¬â¢s number of less than 2300 is laminar fluid flow, which is characterized by constant flow motion, whereas a value of over 4000, is represented as turbulent flow. Turbulent flow is characterized as chaotic and irregular flow.[56] Disregulation disorders of blood pressure control include high blood pressure, blood pressure that is too low, and blood pressure that shows excessive or maladaptive fluctuation. Overview of main complications of persistent high blood pressure. Arterial hypertension can be an indicator of other problems and may have long-term adverse effects. Sometimes it can be an acute problem, for examplehypertensive emergency. All levels of arterial pressure put mechanical stress on the arterial walls. Higher pressures increase heart workload and progression of unhealthy tissue growth (atheroma) that develops within the walls of arteries. The higher the pressure, the more stress that is present and the more atheroma tend to progress and the heart muscle tends to thicken, enlarge and become weaker over time. Persistent hypertension is one of the risk factors for strokes, heart attacks,heart failure and arterial aneurysms, and is the leading cause of chronic renal failure. Even moderate elevation of arterial pressure leads to shortened life expectancy. At severely high pressures, mean arterial pressures 50% or more above average, a person can expect to live no more than a few years unless appropriately treated.[60] In the past, most attention was paid to diastolic pressure; but nowadays it is recognised that both high systolic pressure and high pulse pressure (the numerical difference between systolic and diastolic pressures) are also risk factors. In some cases, it appears that a decrease in excessive diastolic pressure can actually increase risk, due probably to the increased difference between systolic and diastolic pressures (see the article on pulse pressure). If systolic blood pressure is elevated (>140) with a normal diastolic blood pressure ( Blood pressure. (2017, Feb 22).
Locke teaching on the individuals right to private property Essay - 1
Locke teaching on the individuals right to private property - Essay Example In this book he discusses how humans have a right to property and how and to what extent this affects the God. He advocated that although humans resided in a socially set system but all could not be treated the same way. He believed, ââ¬Å"... a thinking, intelligent being, that has reason and reflection, and can consider itself as itself, the same thinking thing in different times and places, which it only does by that consciousness which is inseparable from thinkingâ⬠(Ariew & Watkins 370). The capability to think, analyze, reason and evaluate separates us from animals. Reasoning and reflection is because of what one experiences on its own and every individual has a different experience. He concluded that humans speak patriarchal with time .all men are blessed with certain traits and presents by the sovereign. In short, every person is responsible for his own self. Hence, man would do his best to explore and benefit from his potentials. It is not obligatory to benefit from th ese gifts. It's on the person himself. . Every person has the choice of benefiting from his capabilities thus he's responsible for his own self. This theory can be explained by numbering and quantifying the labor involved. Labor either physical or mental bears fruits for the person and his property. He believed that decision was on our own not the sovereign as we choose the best for you
Thursday, September 12, 2019
Entrepreneurial Interview Research Paper Example | Topics and Well Written Essays - 750 words
Entrepreneurial Interview - Research Paper Example The sight of bricks and blocks being placed on top of each other thus making walls and rising into structures fascinated me. I loved the smell of the wet cement as the walls were plastered and would often sit inside the cured plastered building to keep safe from the scorching heat of the sun outside. I was good in studies. After my higher secondary school exam, I got admission in an engineering university. I became a Civil Engineer in four years. When I was granted admission, at that time the scope of Civil Engineering was lesser than that of Electrical or Mechanical Engineering. However, while I was studying, the scope of Civil Engineering increased manifolds particularly as new opportunities of construction and development surfaced after wars in Iraq and Afghanistan. I had joined that course with the view that whether or not I would get the job, I would establish my own business utilizing the skills and experience of my father. When I graduated in 2008, I opted to seek practical experience in field before establishing my own company. I deemed it necessary to seek practical experience first in order to familiarize myself with the complications of the construction work and the way day-to-day challenges are met in construction work. I was fortunate to work at a big project ââ¬Å"Canyon Viewsâ⬠by a prestigious client EMAAR in Islamabad. Meanwhile, I got myself registered with Pakistan Engineering Council (PEC). After about a year of experience, I decided to establish my own company. I compiled the necessary documents and applied for a company in PEC. Within a period of three to four months, I had my own company established. I set up my own office of design and consultation. My father had been constructing houses for over 20 years. I started to supervise the construction and brought improvement in the structural design of the houses so as to make them structurally safer than the old designs. After the houses were constructed,
Wednesday, September 11, 2019
The Marketing Mix Essay Example | Topics and Well Written Essays - 3000 words
The Marketing Mix - Essay Example But in other instances, the marketing mix included product planning, pricing, branding, distribution channels, personal selling, advertising, promotions, packaging, display, servicing, physical handling, and fact finding and analysis Brassington and Petit (2000) emphasised that marketing includes ââ¬Å"â⬠¦absolutely essential business activities that bring you the products you do want, when you want them, where you want them, but at prices you can affordâ⬠¦Ã¢â¬ These statements, including ââ¬Å"The marketer has to ensure that the marketing mix meets the customerââ¬â¢s needs and wants,â⬠from Brassington and Petit only means that the customerââ¬â¢s needs and wants shape the way marketing executives and companies in the conceptualisation, presentation and delivery of products and services. One example of this is Nokia. Nokia from Finland have consistently provided cutting edge technology in the mobile phone industry catering mostly to young, mobile urban market aged 18 to 39. Their leading the industry was due to their compact designs and variety of optional services provided for by their phones which at launching, were definitely not available among its competitors. Previously dominated by Motorola, Nokia combined a marketing mix of reasonable price, new product that delivers, as well as accessibility that the young market were looking for which was then not available. In a 2003 marketing campaign, Nokia tied up with DVC Worldwide in the launching of camera phone 3650. Appealing generally to tech and media-savvy teens, Nokia went beyond standard marketing and advertising channels by inserting its brand into the consciousness of dominant young teenager females that actually influence the buying behaviour of other teens (Mucha, 2003). The strategy identified "social leaders" of teen groups that in turn informed DVCX how and where to promote the product hitting restaurants, malls, and even high school parties in order to introduce and demonstrate the camera phones across seven U.S. key areas Atlanta, Boston, Chicago, Detroit, Los Angeles, New York and San Francisco. DVCX president John Palumbo was quoted saying, "We try to find the right places, the right times, the right fit You merge the brand into their lives." The report had also indicated other strategies used for Nokia 3650 of giving "alpha teens" free phones and three months of free service, $50 rebates to people who voluntarily e-mailed camera photos to their friends, so that the campaign reportedly reached 200,000 potential customers, teens walking away with more than 100,000 rebates, 25,000 camera phone pictures snapped at potential customers, 20,000 new e-mail addresses, and a 2,000 contact base of social influencers. Mucha (2003) added that the Nokia teenage girl campaign is a sample of a larger trend called experiential marketing defined by Palumbo as, "marketing programs that involve the target audience with the brand to create an experience. If people remember it, are interested in it, and talk about it, the brand becomes an experience, both physical and emotional," (qtd., Mucha, 2003). Other companies or brands that have launched the same marketing strategy include AT&T, Campbell Soup, Claritin, Apple, Jet Blue, Mini Cooper and Nike which brands were "all designed to involve people" (Palumbo qtd. in Mucha, 2003) and hoped to
Tuesday, September 10, 2019
Interview Questions Essay Example | Topics and Well Written Essays - 1000 words
Interview Questions - Essay Example The interview questions will be divided into five groups targeting different data set and they will include: 4. Do you think that religious scholars and liberal oriented society members can get together for a common cause? What do you think would be the common ground that could bring these two different oriented societies together? How will this collaboration be helpful in the development of the society and what would be the possible outcome? Will this outcome be beneficial? 12. Do you think your organization is among the organizations that could serve as a mediation point between society and government? If so, in what manner and on what issues can it mediate and the instances that it has already mediated. 10. Do you think that the leap in technology and media are helping the Saudi women in sharing her interests and thoughts to other women in society? What other ways do you think exist that may allow Saudi women to be more actively effective in
Monday, September 9, 2019
Working with children and families case study Essay
Working with children and families case study - Essay Example The different aspects of intervention in the families are historical, social, psychological and legal in nature. These aspects are incorporated in the guidelines that are being followed by the social workers to resolve the case specific problems of the clients (Hepworth et. al., 2009; The historical aspect is one of the facets in the implementation of family intervention. This aspect is important to be able to determine the possible causes of the situation wherein intervention is required as well as the background information for assessing the needs of the person. Included in the historical aspect are the family members in the household and the relationship to the person in need of assistance. Another factor included in the said aspect is the experiences of the parents and the events that had happened in the family that may have triggered the problematic situation. The interactions and interrelationship between family members that may have directly or indirectly affect the perspective and disposition of the person in focus. In addition, the strengths and the weaknesses of the parents that can trigger the changes in behaviour and way of thinking of the person are also included in the fundamental historical components of the family intervention (Horwath, 2000, p.56 , 80-82). For the child Debbie, the members of her immediate family are in the household, her parents and her siblings. Historical aspect of the intervention includes the relationship between the family members and their effect on the child. Her mother Irene is agoraphobic and her brother is severely disabled. Other issues make matters worse such as the situation of the father John who is not employed. The conflicts within the household are having effects on Debbie and Hannah who are exhibiting violent behaviours and problems in learning. The social aspect of the intervention in the family is another area of importance. This can be
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