Ocular Visit Essay Example

Ocular Visit Essay The  Barangay is the  basic unit of government here in the Philippines. According to the address of Senator Bongbong Marcos in Liga ng mga Barangay’s 1st General Assembly held at Heritage Hotel Manila, it is the soul of local government autonomy. We are to select a barangay that is the beneficiary of our chosen project. We chose the Barangay Salinas 1, Bacoor City,  in the  province  of  Cavite,  Philippines because last July 10,2013, several houses were burned that caused some families to become homeless. In the Barangay of Salinas 1, they belong to a first class municipality in terms of income. It is also convenient for them because SM City Bacoor is near the vicinity. The neighbourhood we entered is peaceful. I have also observed and learned that there are many town homes subdivision and there are two phases of Meralco Housing project located in this barangay. There is also an elementary school with covered court and children center in which the environment is conducive for learning. Good thing also is that there are trees in some household and there is also grass area. Local government officials are also working to improve their barangay. They posted accomplishment reports in their barangay hall to showcase their implemented projects like the constructing a waiting shed entitled: â€Å"Silungan ng mag-aaral umulan man o umaraw† headed by Sanguniang Kabataan. There are also some negative aspects or weaknesses in the barangay of Salinas 1. One is that the barangay is beside a river so it is located in a flood plain. There will be occasional flood in the area especially if heavy rain continually pours. I also observed that small roads and less social interaction in the neighbourhood. We will write a custom essay sample on Ocular Visit specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Ocular Visit specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Ocular Visit specifically for you FOR ONLY $16.38 $13.9/page Hire Writer The children and even some teens are just lurking in the streets. There is also less engagement that inherently creates a community who take pride and self-responsibility for what goes on in their neighbourhood and its outside appearance. The project I would like to propose is a leadership seminar for adults in the barangay ages 21 and above. It is because while we were walking around the neighbourhood, I noticed that there is less interaction of people living in the neighbourhood. Through this project, it will allow people to resolve collective problems more easily. The community will be able to advance more smoothly. Sometimes, they won’t have to rely on local government to keep their infrastructure and the environment in tip-top shape. Another is for health and safety issues. People should know how to take appropriate actions in any situation especially that there was a fire that killed a five-year old boy. And lastly, for the importance of community dialogue. Every barangay needs leaders who understand the importance of public discourse and civic conversations who can also connect with the local officials.

abraham lincon essays

abraham lincon essays President Abraham Lincoln was the 16th President of the United States. He was the president during the Civil War when he fought for slave rights and ended up freeing the slaves. His life ended on April 15, 1865 at the hand of a killer named John Wilkes Booth while attending a performance at Fords Theater in Washington D.C. On February 12, 1809, the son of Thomas and Nancy Honks Lincoln was born in a log cabin in Harden County, Kentucky. They named him Abraham after his grandfather. Having no education, Thomas Lincoln, Abrahams father worked as a farmer, as his family made repeated new starts in the west. When little Abraham was eight years old, his family moved from Kentucky to Indiana, where he grew up in a wild region, with many bears and other wild animals still in the woods. Abrahams childhood was spent in a poor life, as opportunities for education and cultural activities on the frontier wes poor. In the year of 1818, his mother Nancy died of a frontier decease called Milk Sickness. Only one year after Nancys death, Abrahams father, Thomas, married a woman named Sarah bush Johnston, a mother of three children, who became Abrahams stepmothe. Sarah made sure that the by Abraham received at least some schooling to read and write. The Lincolns lived in Indiana for a period of fourteen years. Abraham was raised on hard farm work and hunting. He grew strong and very tall. He was in height, six feet, four inches, nearly weighing, on an average, one hundred and eighty pounds; he had black hair, gray eyes. To support the poor family, Thomas Lincoln kept Abraham busy at farm work until Abraham was twenty-two years old. In the year of 1830, the Lincolns decided to leave the state of Indiana, because they hoped of a better future and moved to the state of Illinois. Abraham settled in the town of New Salem, Illinois, where he began his education by study ...

Common Biases in Self-perception Essay Example | Topics and Well Written Essays - 1000 words

Common Biases in Self-perception - Essay Example 387). People reactions in situations originate in the very perceptions. In order to change people’s reactions and responses to the challenges of everyday life, it is imperative that biases in self-perception, factors governing the self-perceptions, people’s tendency and willingness to change their self-perceptions for the better, and possible ways to achieve this are explored. A very common misconception about the perceptions is that they are passive and are created as a result of an individual’s recorded information about the subject from the past experience. In reality, perceptions are active and create reality rather than recording it depending upon an individual’s response to the stimuli (Curry, Meyer, and McKinney, 2006, p. 28). Self-perceptions play a big role in the quality of performance of an individual. Yammarino and Atwater (1993) proposed a model according to which accurate self-perception leads to better individual and organizational outcomes whereas inflated or deflated self-perception leads to diminished or mixed results respectively. The behavior and psychology of an individual is different when he/she is working as part of a group from when he/she is working alone. Generally, people tend to have self-serving biases when they are being part of a team. They tend to take credit for the team’s successes while indulge in a blame-game to avoid the responsibility of failure (Taylor and Doria, 1981, p. 210). Factors that help an individual carry accurate self-perceptions include but are not limited to high self-esteem, knowledge, and good critical analysis skills. Reifenberg (2001, p. 627) found that people who make good judgments about their performance have higher internal attributions than others whose judgments are not quite as good. Lack of the skill to respond accurately to particular situations at hand arises from lack of people’s awareness of their lack of ability to differentiate between the accurate a nd inaccurate response to the very situations. This essentially means that rather than being ignorant of their lack of skill to respond accurately, such people are ignorant about their ignorance. Instead of realizing their deficiencies, these people tend to overestimate their skill of responding in the right way thinking there is no problem all which is how their ignorance works. People with low talent are more optimistic about their performance as compared to the people with high talent. Indeed, the latter are slightly pessimistic about their performance not because they underestimate their own skills, but because they tend to overestimate the skills of others, whereas actually others are not as good at responding in the right way as they are. On the other hand, the optimism of the people with low talent originates in their lack of knowledge, thus causing them more trouble with their metacognitive judgments. Failure of these people to realize their incompetence is because of the fa ct that they are doubly cursed in that they are not only unable to make the right response but are also unable to differentiate between the right and wrong response. â€Å"[I]ncompetence means that people cannot successfully complete the task of metacognition, which, among its many meanings, refers to the ability to evaluate responses as correct or incorrect† (Dunning et al., 2003, p. 85). Others’

The Killing of Osama Bin Laden by United States Forces Dissertation

The Killing of Osama Bin Laden by United States Forces - Dissertation Example Only the courts have the right to sentence a criminal or the erring to death or imprisonment. On 2 May 2011 Osama Bin Laden was killed. President Barack Obama’s 2 May 2011 account of the circumstance of the killing is this: â€Å"†¦We quickly learned that the 9/11 attacks were carried out by al Qaeda --- an organization headed by Osama bin Laden, which had openly declared war on the United States and was committed to killing innocents in our country and around the globe. And so we went to war against al Qaeda to protect our citizens, our friends, and our allies†¦.I directed Leon Panetta, the director of the CIA, to make the killing or capture of bin Laden the top priority of war against al Qaeda, even as we continued our broader efforts to disrupt, dismantle, and defeat his network†¦.Today, at my direction, the United States launched a targeted operation against that compound in Abbottabad, Pakistan. A small team of Americans carried out the operation with extraordinary courage and capability. No Americans were harmed. They took care to avoid civilian casualties. After a firefight, they killed Osama bin Laden and took custody of his body.† British Broadcasting Company’s documentation of President Barack Obama’s 2 May 2011 statement on Osama bin Laden’s death corroborated the version posted in the official webpage of the White House. The British Broadcasting Company’s documentation of Obama’s 2 May statement reflected that President Barack Obama said that Osama bin Laden was killed AFTER and NOT DURING A FIREFIGHT. The 2 May 2011 press briefing provided by the US President Office of the Press Secretary via conference call described the Obama killing in this manner: â€Å"Bin Laden was a sworn enemy of the United State

Outcome Analysis of Burns Patients in BICU

Outcome Analysis of Burns Patients in BICU Outcome analysis of burns patients after admission to burns intensive care unit in a tertiary regional referral centre Goh SY, Thong SY, Win MTM, Ng SY ABSTRACT Background: The clinical course of severely burned patients may be stormy and the prognosis tends to be poor in patients with multiple comorbidities and those with inhalational injury. The aim of this study is to develop an objective and reliable predictive model for mortality in patients with major burns. This will help us identify the important factors influencing outcomes and allows more evidence-based prognostication. Methods: Adult patients admitted to the burns intensive care unit (BICU) in a major tertiary referral center from 2008-2011 are selected. Demographic factors, types, severity and complications of burn injury as well as outcomes are reviewed. Results:In the 4-year period, 181 patients were admitted to BICU. Mean age (SD) was 41 (16) years old. Mean (SD) total body surface area burn was 37.2 (30.2%). Mortality was 39.5%. Mean (SD) length of stay in the BICU and hospital for patients who eventually survived were 8.4 (13.4) and 28.5 (37.9) days respectively. Lower airway burns has a significant relationship with the development of renal failure after multivariate analysis (Odds ratio 5.1, Confidence interval 1.1- 24.0). Greater total body surface burns, development of acute respiratory distress syndrome and older patients with more extensive burns predispose to mortality as shown in table 2. In our cohort of patients, the probability of death may be estimated by this equation: Probability of death= (1+ey)-1 y= -7.008+0.04(TBSA) +1.791(ARDS)*+0.054(Age+TBSA) *= ARDS (0=no, 1=yes) Conclusion: We have developed a predictive model for mortality in major burn patients. This may be useful in prognosis during early stages of care. Introduction Survival after burns injury has improved tremendously over the last few decadeswith the refinement of fluid resuscitation, better intensive care and early surgical excision1as some of the strategies that have significantly influenced patient outcomes. These advancements have contributed to lowering mortality rates in burns patients in Singapore to 4.5% between 2003-20052. Despite these advancements, however, overall mortality rates of patients with major burns remain high. Numerous factors such as age, percentage body surface area burns and inhalational injuries3 have been found to influence the prognosis and outcomes in this group of patients. The combination of these predictive factors into scoring systems that would yield an expected mortality rate for each given patient has been the subject of many studies4-6.However, most of these studies have not been performed or validated in our local population. A robust predictive model would be useful for clinicians as a more evidence-based approach for counselling and prognostication at an early stage of treatment. We can even plan further treatment and intervention based on prognosis and other clinical factors. A standardized model will also provide an opportunity for audit and a basis against which new treatment modalities may be compared. Therefore, the objective of this study was to identify the prognostic variables influencing outcome in patients admitted to our burns intensive care unit and to develop a predictive model for mortality in patients with major burns. Methods Clinical care The burns centre at the Singapore General Hospital is a major tertiary referral centre for burns injury in Singapore as well as the Southeast Asia region. Burn patients presenting at the Accident and Emergency department are assessed by the plastic surgerical team, who decide if the patient requires admission to the specialised burns unit or the burns intensive care unit. The extent and depth of burns were assessed and documented.All patients requiring intensive care, such as those with major burns, are haemodynamically unstable, or have sustained inhalational injury requiring mechanical ventilation, are managed by a team consisting of at least a plastic surgical specialist and an anaesthetist. These patients received fluid resuscitation according to the Parkland’s formula. Adequacy of fluid therapy was assessed by endpoints such as hourly urine output, arterial blood pressure and central venous pressure. Early enteral nutrition, mechanical ventilation and vasoactive support were initiated as required. Early surgery for escharotomy, burns excision and grafting were carried out as early as possible. Patients This study was approved by our centre’s institutional review board. The medical records of all burns patients admitted to the burns intensive care unit at the Singapore General Hospital over a 4-year period between January 2008 and December 2011 were reviewed retrospectively. Information including demographics, comorbidities, mechanism of injury, total body surface area (TBSA) burned, incidence of inhalation injury, complications such as organ failure, length of hospital stay and mortality were recorded and entered into a database. Statistical Analysis Statistical analyses were conducted using the Statistical Package for the Social Sciences (SPSS version 17, SPSS Inc., Chicago, IL). Data are presented as mean and standard deviationfor continuous variables and proportions for categorical variables. Univariate comparisons of proportions and means were respectively done using Chi Square test, Fisher exact test and t test. Logistic regression and linear regression analysis was applied to study the relationship between the variables and mortality and length of stay, respectively. Variables with a plausible relationship with mortality or p0.05. Results Patient profile During the 4-year study period, a total of 182 patients were admitted to the burns intensive care unit (BICU).These patient characteristics are presented in table 1. The mean age of these patients was 40.5 +/- 16 years old, with males comprising a larger percentage of the cohort (79.1%). Mean total body surface area (TBSA) burned was 37.2 +/- 30.2%. Most of the patients were healthy prior to their burns, with only a small minority having any significant medical issues. A high proportion of the patients suffered inhalational burns (83%). However, only 26 out of the 182 patients (14.3%) fulfilled the criteria for ARDS. Other significant patient characteristics and details of their burns injuries are listed in Table 1. Flame burn was the commonest injury etiology in our patient population (88.4%). Table 2 shows the mechanism of burn injuries suffered by our group of patients. Length of stay The mean length of stay was 20.9 days. The survivors spent a mean of 8.4 days in ICU, as opposed to 6.9 days for the non-survivors. The majority of patients who survived to discharge were discharged home (table 3). TBSA, albumin level and sepsis were found to be significant predictors of LOS, yielding a final predictive model of: LOS = 41.608 – 0.234(TBSA) – 0.919 (albumin) + 16.14 (sepsis*) Where *=presence of sepsis (yes=1, no=0) Mortality Out of the 182 patients, a total of 65 patients or 35.9 % did not survive the hospital stay. The mean age of these patients was 42.1 years. Mean TBSA involved was 66.8% (compared with a mean of 20.6% in the survivor group). In our analysis, we found that the non-survivor group had significantly larger TBSA burns (p To develop the predictive model, we analysed the variables in univariate analysis. Variables with a plausible relationship with mortality or p A predictive model for mortality was thus developed as follows: Probability of death = (1+ey)-1 Where y = -7.008 + 0.04 (TBSA) + 1.791 (ARDS)* + 0.054( Age+TBSA) * = ARDS (no=0, yes =1) Discussion In this study, we elucidated the risk factors that contribute to mortality in patients admitted to the BICU, and developed a predictive model for mortality incorporating these factors. Previous mortality studies have sought to establish prognostic variables associated with burn mortality. In 1961 Baux described in a French thesis a simple empiric formula, stating that mortality rate was the sum of age and percentage area burned7. Inhalational injury was then found to be an important predictive factor and this was included in a mortality probability equation reported by Clark et al in 19868. The abbreviated burn severity index (ABSI), which is in widespread use, assigns numerical values according to the severity of 5 prognostic variables (age, gender, inhalational injury, %TBSA and presence of full thickness burns). The sum of these variables yields a predicted mortality rate9. Similar predictive factors have been found to be relevant in several other studies3,10,11. However, these st udies generated highly variable predictive models, highlighting the need for individualised models for different patient groups. Our study is unique as it is one of only a handful of studies based on an Asian population2,12-14 , with even fewer attempting to develop predictive mortality models5. In addition, we only included burns intensive care unit patients in our study, as opposed to the entire burn population. Advancements in medical care and aggressive early excision and grafting of burns have led to a global reduction in burn mortality in recent times. In Singapore, the overall mortality for burns victims was found to be 4.5% between 2003 and 200512. This improvement has also been evident in severe burns victims, with mortality falling annually from 60% in 2000 to 30% in 20032. However, death rate remains high in this group of patients, and it is our aim to look at the outcomes and predictive factors determining mortality in this susceptible group, and to develop a clinically relevant predictive model targeted at them. Our study found that TBSA, age+TBSA and ARDS were significant predictive factors affecting mortality in our ICU patients. Inhalational injury, generally accepted as a prognostic factor8,9, was not found to be significantly associated with death in our patient group. There could be several explanations for this finding. In our series, 151 or 83% of our patients were diagnosed with inhalational burns. This is a very high percentage compared to most of the other studies, though it is not entirely surprising. Our patient cohort consisted entirely of ICU patients. This unique group of patients have either sustained major burns or inhalational burns that have required ventilatory support. . The remaining 17% of patients that might have been in ICU due to reasons other than inhalational injuries may not have been sufficient in number to demonstrate a survival advantage, if any. Secondly the lack of universally accepted diagnostic criteria means that the diagnosis of inhalational injury can vary widely between different institutions and intensivists, using either clinical examination or fibreoptic bronchoscopy, or a combination of both. Hence it has been suggested that, the need for invasive ventilation, the determination of which is far less complicated than the diagnosis of inhalational injury, may be a better marker for mortality risk6. In our study, we found that the presence of acute respiratory distress syndrome (ARDS), a common complication associated with major burns or severe inhalational injury, was directly associated with death. This could be an indication that the severity of inhalational injury, rather than the presence of it, may be a more suitable prognostic indicator for death, particularly in the group of patients requiring intensive care management. Since this is a retrospective study, we were not only able to collect data relating to the patient’s characteristics at presentation, but also susbequent clinical data as treatment progressed, such as development of ARDS, sepsis and renal failure. Clearly these factors are important as response to therapy is a vital determinant to patient outcomes. However, inclusion of these variables may not be possible at patient presentation, the point at which prediction of mortality is sometimes vital for determining the direction and aggressiveness of therapy. Perhaps future prospective trials can look at determining predictive factors that influence mortality at various stages of treatment, creating a superior prognostic tool with which we may advise patients and families, guide therapy and perform internal audit and research. Clinicians utilising any kind of predictive model to estimate mortality probability in the clinical setting should always proceed with caution. These may be used as a tool to aid clinical decisions regarding treatment but should not replace sound clinical judgment. Neither should the outcomes be judged solely upon whether the patient lives or dies, without scant consideration for the quality of life after the hospital stay. These endpoints are a lot more difficult to assess, and in the absence of a standardized tool the incorporation of quality of life indicators into prognostic scoring systems may still be a long way away. Conclusion In our study, we have developed a predictive model for mortality in our cohort of burn patients admitted to the burns intensive care unit. The next step would be to validate the model in future prospective studies. A validated model can potentially help teams involved in tough clinical decisions to prognosticate and formulate treatment plans for severely burned patients. It also serves to show that further studies need to be done to validate and come up with a more robust model. We did not find a significant relationship between inhalational injury and mortality in our study, a finding consistent with several other studies.

Death Penalty Essay -- essays research papers fc

Thesis It is more reasonable to utilize the death penalty than to abolish it. The death penalty should not be abolished because (1) it deters people from committing murder and (2) because the death penalty gives peace of mind to the victims and their families and puts an end to the crime.  Ã‚  Ã‚  Ã‚  Ã‚   Arguments for the thesis (1) The death penalty should not be abolished because the fear of the highest form of punishment will keep potential victims alive. (2) The death penalty should not be abolished because the families of the victims can only begin the healing process once the murderer is put to death. Response to objections to the thesis (1) Objection: The death penalty should be abolished because even the highest form of punishment will not remove the evil from society. Response: If the death penalty was abolished, the convicted murderer has the potential to escape and kill again. This will spread more evil and give the option to kill again to the murderer. (2) Objection: The execution of a convicted murderer will never bring the victims back to life. Therefore it serves no purpose other than to kill.  Ã‚  Ã‚  Ã‚  Ã‚   Response: Resurrection has never been the purpose of the death penalty. The family members just want to start healing and they can’t while the perpetrator is still alive. Bibliography Van der Haag, Ernest and John P. Conrad, The Death Penalty: A Debate (New York: Plenum Press, 1983). Arlen Specter, â€Å"Congress must make Death Sentences Meaningful Again† (Human Events, July 1994). Hugo, Adam Bedau, Ed., The Death penalty in America: Current Controversies (New York: Oxford University Press, 1997) Blumstein, Cohen, Nagin, Deterrence and Incapacitation (National Academy Press January 1978) It is more reasonable to utilize the death penalty than to abolish it. The death penalty should not be abolished because (1) it deters people from committing murder and (2) because the death penalty gives peace of mind to the victims and their families and puts an end to the crime. The death penalty deters some people from committing heinous crimes and thereby also saves human lives. Not everyone will be deterred from committing heinous crimes because of the death penalty. However, since the death penalty is the highest penalty for crimes it will obviously evoke the most fear in a human being. This fear will save... ...rt the healing process. If a state governed by law is to be able to show warmth, compassion and peace of mind to victims and their families, then the death penalty is the most effective way to bring this about. The argument to the above is that the death penalty does not bring back any victim to life, therefore, unnecessary. Just because someone has taken a life, it doesn’t mean that the convict’s life should also be taken. Is it fair to take a bad situation and make it worse? The death penalty will never sweep away the emotions and feelings of grief that the relatives and friends feel. Murdering the convicted murder would only cause more grief for his family, therefore, over time, grieving would become commonplace. Resurrection has never been the purpose of the death penalty. It is understood that the death penalty will not totally take away the emotions and feelings of the relatives, however the death penalty will ease those pains. The grief and despair would be considerably heavier to carry if the relatives knew that the perpetrator was only sentenced to prison and would be released after a period of time. Therefore, I feel that the death penalty will never become unnecessary.

The importance of music

Music first formed in ancient time and continued to develop simultaneously with civilization. It is said that without music, our world would become boring. Why music is so Important? Why many people spend a lot of time on listening to music? In fact, music affects us more than we know. Music plays Important roles in our life: It connects people, entertains us and has other uses In particular times. First, music connects people. Different ages, different classes of people come closer getting know each other through music.Specifically, many international encores was held worldwide in a Joint effort to exchange culture and struck up or develop friendship. The countries, as a result, can lead to a multilateral development agreements. Moreover, the people in those countries can be pleased thanks to the influence of music idols. In addition, music can heal the breach between people. It reduces seriousness among those who are in debates. Familiar melodies bring back their memories, throw th em back to their happy time In the past and it reconnects them In spiritual level. Besides, music encourages humanitarian actions.People often hold charity concerts and music makes them easy to emphasize with unfortunate lives. In other words, music brings us together. Second, music entertains us In many ways. After long hours working hard, listening to our favorite rhythm can help us relax or even stimulate our brain in order to keep on working efficiency. Furthermore, after a stressful day, music is one of the best ways to entertain. It can be exciting, gentle or soft, depending on the listeners' sense. An amazing way to enjoy music is to attend concerts, theaters or just turn on TV and sites to our favorite songs.Moreover, if you can play musical instruments, it will be the best way to enjoy music. Playing music by ourselves, we understand completely the song and get closer to the singer. Music is an important part of our life. Entertainment Is the thing cannot be denied when we talk about music. Finally, music also has many good uses to people. Apparently, with music, we can express ourselves, our feeling, our thought and our emotion. For example, when we are sad, we prefer to listen to sad song like † unchain melody † In order to show our sadness. Moreover, music can create particular atmosphere for different situation.For instance, people prefer to open solemn music in some formal occasions. One more use of music is that it builds up nation esteem. Specifically, when listening to nation anthem,we are proud of our country more than ever. In short, music has many incredible uses that strongly affect our thoughts, our emotion and our work. In summary, music plays important roles in our life. Not only are the young people influenced by music but also the old can't help enjoying the rhythm. Music relaxes us, assists us with many good things but its uppermost effect Is to bring us together.It is hard for us to Imagine a world without music, that wo uld be boring and full of sadness. The importance of music By painlessly 2 is so important? Why many people spend a lot of time on listening to music? In fact, music affects us more than we know. Music plays important roles in our life: it connects people, entertains us and has other uses in particular times. Their memories, throw them back to their happy time in the past and it reconnects them in spiritual level. Besides, music encourages humanitarian actions. People often Second, music entertains us in many ways.After long hours working hard, listening to amazing way to enjoy music is to attend concerts, theaters or Just turn on TV and Entertainment is the thing cannot be denied when we talk about music. Finally, music we prefer to listen to sad song like † Unchain melody † in order to show our sadness. Influenced by music but also the old can't help enjoying the rhythm. Music relaxes us, assists us with many good things but its uppermost effect is to bring us together . It is hard for us to imagine a world without music, that would be boring and full of