Change Essay - 865 Words

Change is something that is constantly occurring in our lives. Not a single moment goes by when everything in our lives will remain consistent. Indeed, it has become apparent to us that the only thing which in fact survives change, is change itself. Time and experience allows change to eventually reform and alter everything from the way it originally was. From ourselves physically, to those around us emotionally, to the way in which we perceive the entirety of the world everything it eventually changes. Most of the time we are not even explicitly aware of such changes occurring, but none-the-less they are indeed occurring. Change is a natural process that cannot be easily stopped or controlled. When we think of the things we†¦show more content†¦This short poem, which was present in the stimulus booklet, effectively presents a dramatic monologue which encapsulates the concept of change on a physical, social and emotional level. Through the poem the door, the poet, is trying to convey to the responder, that life is too short for us to simply try and keep things constant at all times. We have to make change our ally and use it to enrich our lives, and allow it to transform us into stronger, superior beings. The poet is integrating the use of dual metaphor, The Door, to convey to us that getting what we want out of life, is as simple as opening a door, and allowing yourself to become exposed to a completely new environment. The poet is addressing today’s society and almost satirising our constant fear of change and failure, conveying to us that even if we take a risk in our life, and we feel as if we are lost, the mist of confusion will eventually lift, and we will be left with an enriched, fulfilled life. This is adamant in the lines â€Å" go ad open the door, if there is a fog, it will clear.† Miroslav Holub, is telling us that we need to embrace as change will always be present in our life, a nd it is only through change that we can grow and form as strong passionate beings. However, although we have come far as a society, and can now only embrace change but seek to instigate it, there are still some parts of modern living which always seem to remain constant, and refuse to embrace change and this isShow MoreRelatedThe Change Of A Change Leader973 Words   |  4 Pagesbelieve that the change that is to occur has a large part on the strategies that a change leader must use to build employee commitment and buy-in. According to Palmer, Dunford and Akin (2009) â€Å"Getting people to buy-in may depend upon what it is that they are buying into: whether they perceive it as favorable to them and whether the change had been adequately justified to them† (p.302). 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Having to change your lifestyle after being paralysed in a car accident. Im

Geographical Discoveries Free Essays

Great geographical discoveries – a popular term geographical discoveries made at the turn of the fifteenth and sixteenth centuries, in particular: circumnavigation Cape of Good Hope by Diaz (1488), the discovery of America by Columbus (1492), and then the conquest, trip [[Vasco da Gama | to India (1498) and the first trip around the world, Magellan (1519-1522). These events triggered a further voyages of discovery and contributed to a significant widening of the geographical horizon of Europeans. Expedition of Christopher Columbus Rulers of Spain, they realized that they begin to lose the distance to Portugal, which definitely lead the quantity organized expeditions. We will write a custom essay sample on Geographical Discoveries or any similar topic only for you Order Now But so far Spain was busy fighting with the Arabs, who defended her at the last stronghold – Grenada. When in 1492 the Saracens were expelled from the Iberian peninsula, Ferdinand and Isabella agreed to finance the expedition, which presented them with a description of the Genoese Christopher Columbus. The traveler asked the first king of Portugal. Presented a plan aimed at shipping on the west and in accordance with the map of Ptolemy, after crossing the Atlantic to reach Asia. However, not met with favor. With the same plan, asked the king of Spain. Under the agreement, written by Columbus from the royal couple: Columbus was appointed for life admiral, governor and viceroy of the newly discovered lands. 1 / 10 of income from the newly discovered land was to belong to Columbus, the rest of the royal treasury. In return, Columbus promised to cover 1 / 8 the cost of the expedition. The rest covered the royal couple. And the expedition of Christopher Columbus (1492-1493) The expedition set sail on August 3, 1492 from the port of Palos de la Frontera. The first stage of the journey were previously discovered the Canary Islands, then Columbus sailed along the 28 parallel to the west. The crew, consisting of about 90 people after 3 weeks of shipping began to rebel, when it turned out that you can not see land. 29. 09. Columbus in his diary wrote that it was rebellion. 11. 10. Columbus erected ultimatum – if within 24 hours will not see the land has ordered outflow. Fortunately for Kolumba12 October after three months of the expedition, when the entire crew of the ship was already tired and actually threatened Columbus’s death, Juan Rodriguez Bermejo saw the crow’s nest land. The expedition landed on the island probably Watling (called Guanahani by the Indians), a small island group of the Bahamas. In the natives pointed gold ornaments. Interviewed about their origin indicated the direction to the south. Judging from this that lies to the north of the mainland, Columbus chose a new course to the southwest. Indians called the island’s inhabitants. October 28 Columbus arrived in Cuba, then on December 6 found another island of Haiti / Hispaniola and the smaller islands, which he called Isabella and Fernandina in honor of the royal couple. Then there was a crisis – in late January and February turned out that the admiral ship sank and the Santa Maria, Columbus ordered the return to their homeland. In March 1493, two ships returned to Palos. Second expedition of Christopher Columbus (1493 – 1494) September 25, 1493, the expedition set off another. This time the expedition better equipped, numbering more ships (about 15, the number of crew: about 1750). The expedition lasted 1. 5 years. This time, Columbus chose a more southern route, and thus reached land in the area of the Lesser Antilles. Subsequently discovered the island of Dominica, Marie – Galante, Guadeloupe, Antigua and Puerto Rico. Nov. 22 Columbus arrived in Haiti again, to see that the people left there, no one survived. How domyslono, all perished in the struggle with the natives. In the longer journey Columbus sailed along the southern coast of Cuba and discovered Jamaica. However, the absolute gggaaaTymczasem proceeding to Columbus alienated a large part of his crew. Discouraged many hardships and lack of legendary riches separated themselves from the trip and started searching on your own. Others returned to Spain, choking many complaints on Columbus. Influenced by the enemies of Columbus postulated to take privileges granted to him earlier, and in his place appointed royal governor of the newly discovered lands. In this situation, Columbus on March 19 headed back to Spain, where he arrived June 11. At the court managed to clear himself of the charges against him, obtained a confirmation of earlier privileges and the promise of organizing the next, the third expedition. Third expedition of Christopher Columbus (1498 – 1500) Another, already the third expedition took place in 1498 on her organization had to wait so much, because it failed to fully restore confidence in what it darzono. In fact, only during this expedition, Christopher Columbus saw the mainland. It was South America, but that’s when fate turned away from Columbus. Columbus autocratic favor of his people, in particular his son – Diego. She came to the undoubted frustration at the lack of major economic successes and difficulties expeditions in relations with the natives. Just as during the second expedition, news arrived of the problems to the crown. Meanwhile, it was decided to act more decisively. In June 1500 sent to the west of Francis Bobadilla, which were endowed with wide powers of attorney. After reviewing the situation in Haiti, he ordered arrest of Columbus and his son, and shackled to send them to Spain. At the Columbus site again managed to clear themselves of charges and return to the graces of the royal pair. The result was a fourth and last expedition of Columbus to America. IV expedition of Christopher Columbus (1502 -1504) May 9, 1502 flotilla of four ships and 150 crew company Columbus went west again. This time the situation was urgent. In the meantime, Vasco da Gama discovered the route to India around the African continent. Columbus urgently needed was a success proving that the road to the west is shorter, more comfortable and safer. Columbus’s intention was to find the transition to water, which eventually took him to lead India. He expected to go to the west of Cuba. There was headed in his expedition. Flowing in this direction reached the coasts of Honduras and the Mosquito Coast on the east coast of Nicaragua. There, the natives learned about the â€Å"rich kingdoms† (Mayan civilization, and perhaps even the Inca Empire) and the â€Å"great sea† (Pacific Ocean), which lies further west, but despite strenuous attempts failed to find a water passage to the reservoir. Having lost two of the four ships, resigned to return to Cuba, then to Jamaica. There he was forced to settle the remaining ships aground. Materials originating in the damaged ships were used for the construction of fortified settlements. One of the companions of Columbus, Diego Mendez, the Indian boats set off for help survivors. But it was only after months wandering managed to get to Haiti, where he brought help. In the meantime Columbus was seriously ill and in such condition were transported him to Spain, where he arrived November 25, 1504. Summary of accomplishments of Christopher Columbus Given what Columbus has to say that the end of his life was tragic. After returning from the expedition moved to fourth place Vailadolid seriously ill, and having almost the status of a beggar. He died on May 20, 1506 was actually not knowing that he discovered America. He was convinced that came to Japan, to China, to India, and the mainland, which he saw during the third expedition he considered the biblical paradise. Meanwhile, the Portuguese and Spaniards, and realized that Columbus did not reach India, and discovered a new land. Another version of the last years of his life of Columbus presents a mysterious manuscript of Puri, according to which Columbus had died many years later and still take one-fifth trip to the West Indies. The authenticity of this source is given, however, questioned by most scholars Ferdinand Magellan (port. Fernao de Magalhaes, Spanish. Fernando de Magallanes, born. In the spring of 1480, as amended. April 27, 1521) – Portuguese sailor in the service of the Spanish maritime explorer and adventurer. He called the Pacific Ocean (Pacific). September 20, 1519 set out from Portugal by the western, or by the Atlantic Ocean to the Spice Islands in the Malay Archipelago. The expedition, which sailed under his command as the first circumnavigated the Earth. He died on April 27 killed by the inhabitants of the island of Mactan in the Philippine Archipelago Christopher Columbus (born 25 August or 31 October 1451 in Genoa (Italy) – died. May 20, 1506 in Valladolid, cat Cristofor Colom, owned by Cristoforo Colombo, Spanish. Cristobal Colon) – European sailor and navigator (probably Catalan by recent discoveries), captain of the expedition, which flowed on the three ships Santa Maria, Nina and Pinta under the flag of Castile in search of the western sea route to India, as the first in the history of geographical discoveries of modern beat tropical Atlantic Ocean and 12 October 1492 reached the West Indies (Antilles ) off the coast of America – the continent at that time unknown in Europe. Was appointed as admiral and made the first governor of the Spanish colonies in Central America, the organizer and master of four transatlantic discovery expeditions from Spain to America. Diaz used the discovery of Vasco da Gama. In 1497 another expedition was launched. Da Gama sailed around the Cape of Good Hope and headed towards Asia. Docked in the port of Calicut in India. Returned to the country in 1499 along with a large cargo of gold and spices. The country welcomed him enthusiastically. Maritime route to India became a reality. No wonder that the success of this expedition had a big impact naorganizowanie next. Henry the Navigator Portugal at least because of its location lent itself perfectly to the base for ocean expeditions. Despite the advantages of geographical location odegralaby probably not such a role in the great geographical discoveries, if not enthusiasm and dedication to Prince Henry (1394-1460) Henry called Sailor. After the conquest by the Portuguese in 1415 On the Moroccan coast Ceutry Henry was convinced that further expansion in Africa will bring great benefits. Counting on profits from trading gold, slaves, ivory, and pepper. With his support along the western coast of Cape Sangres organized a sort of database connection with the research center, where he collected all the geographical and navigational data and worked on the construction of sailing ships. For seventy years the Portuguese sailing ships were moving farther and farther south along the African coast, reaching successive headlands: Nun, Bojador, Blanco and 1445 Green Cape. During these expeditions the Portuguese discovered and colonized offshore islands and archipelagos – Madeira, the Canary Islands, Cape Verde. They assumed a fortified factories on the coast. And as it turned out that gold is less in Africa than they hoped, they took a more profitable procedere, the slave trade. EXPEDITIONS: WYPRARY PORTUGUESE: -Henry the Navigator – Azores, Canary Islands, Cape Verde, crossed the equator in 1471r. , -Bartholomew Diaz – 1488r . – Busz Cape (Cape of Good Hope), Vasco da Gamma– the road to India along the coast of Africa (1497-1498), SPANISH EXPEDITION: Christopher Columbus – the discovery of America (12. 10. 1942r), Hispaniola (Haiti), Cuba and others (1492), Lesser Antilles, the Coast of Central America and South America (1493-1503); -Amerigo Vespucci – realized that America is a new continent (from his name, name); -Ferdinand Magellan – (1519-1522) circumnavigation of the Earth (Magellan Strait, Pacific Ocean, Philippines, Borneo) – died in 1521r. In the Philippines, an expedition Sebastian del Cano finished; – Francis Drake (English) – and the circumnavigation of South America (the world); CIVILIZATIONS AND SOUTH CENTRAL AMERICA: Maya: V w. n. e. – The beginnings of civilization in the areas of Central America (Yucatan plw. ) with its capital in Majapan; Economy: -Wypaleniskowa (incandescent), -Grown: beans, wheat, -Craft, art, the pyramid; -Religion based on the sun-god cults, rites – human sacrifice; -Totalitarian power, absolute, hereditary; -The principal adviser to the ruler – the high priest; -Did not know the wheel or arc; -Calendar (365 days divided into 18 months); -Developed astronomy; -Know the time (to understand this concept) decimal system; Were aware of the layout of digits; The Aztecs: The thirteenth century – the beginnings of civilization in the areas of Mexico today, with its capital in Tenochtitlan; -Developed economy; -Grown: tomatoes, cotton, cocoa; -Money: cocoa beans or golden sand; -Tools more advanced than the Mayans; -Construction: the temples; -Ruler chosen from among the administrative units; -Bloody rituals, wor ship of the sun: 1489 – 250 thousand were killed. people as victims of ritual, such as skinned, pulling beating hearts; -Took over the Mayan calendar; Incas: Fifteenth century origins of civilization in the areas of Peru; -Cult of the sun and moon; -A highly developed economy, -Machu Picchu, -Crafts (ornaments of gold); -Totalitarian state, absolute power; -The interests of the subordinated interests of the state; -Residents could not travel to other parts of the country; Courier-Mail (16 thousand. Km of roads) Knotted-letter; -Developed surgery and herbal medicine, hypnosis; 1519r. – Hispanic – Cortez Aztec civilization znieszczenie; XVI – the destruction of the Incas – Izarro; How to cite Geographical Discoveries, Papers

Journal The American College Of Cardiology -Myassignmenthelp.Com

Question: Discuss About The Journal The American College Of Cardiology? Answer: Introduction A pacemaker is a device which is very small in size and is placed in the chest or abdomen. It is help to control the abnormality of the heart beats (as shown in fig. 1). This device works by using low energy electric for prompting the heart to beat at normal rates. Pacemakers are generally used for treating arrhythmias. Arrhythmia is type of dysfunction of the heart where a person suffers from the problems with the rate of the rhythm of heartbeat. In case of arrhythmia, the heartbeat may become too fast or too slow or with an irregular rhythm (Foster et al. 2017). Having a pacemaker can extraordinarily enhance your personal satisfaction and for a few people it can be life saving. Most pacemakers are extremely solid and agreeable. They're littler than a normal matchbox and weigh around 20 to 50 grams. Materials The materials that are used for making the pacemakers must be nontoxic, sterilizable and have the ability to function according to the conditions of the body. The parts of the pacemaker include the casing, electronics and the leads. These parts are generally made up of biocompatible materials. The casing is generally made up of titanium or metal alloy but these are insulated with a polymer such as polyurethane. In this design the metal tip is only exposed and the circuit is generally made up of semiconductors of silicon (Miller, Nazarian and Halperin 2016). The pacemaker generally made up of battery, leads and the circuit which consist of resistors, diodes, capacitors, and semiconductors. The battery is needed to store energy for the stimulation of heart. It is also used to provide the sensors with power. The leads that are used to build up the pacemaker are thin and insulated. For the single chambers pacemakers a single lead is needed and for dual chambers pacemakers, two leads are needed. The modern days pacemakers are a bigger improvement as compared to the earlier models, as the circuit models have become much smaller (Weiss et al. 2013). These results in the consumption of less space in the body; require less energy and are greatly reliable. Mechanism of action The pacemaker helps for monitoring and control the heartbeat. The electrodes present in the pacemaker detect the heartbeat and sends the data through the wires to the computer. If the heart beat is abnormal then the generator will send electric pulses to the heart. Then these pulses travel through the wires and reach the heart. They can also adjust the heart rate so that the heart can work in a better way (Brunner et al. 2014). Clinical safety and efficacy The modern pacemakers are safe to use. According to Khan et al. (2013), the pacemaker can be used during electromagnetic bronchosopy. They had proved that pacemakers of 1.5-T or 3-T magnetic fields can be used in the MRI scanners. They selected some 24 patients with the pacemakers and suffering from lung lesions. Then the electromagnetic bronchoscopy was done, then pacing systems were interrogated and then ECG was recorded. It was seen that there were no disturbances in the pacemaker device and those are working well. It is safe while going through the security detectors of malls, railway stations or airport. They will not damage the pacemaker or ICD. Implantation of the pacemaker for heart is choice of treatment in case of severe or symptomatic bradycardia. So it can be concluded that electromagnetic Navigation Bronchoscopy is safe to perform in the patients having pacemakers. Generally now-a-days, pacemaker implantation has been greatly evolved. Some highly sophisticated devices ar e now available in the market which provides optimal support for the treatment of any type of arrhythmia. In the second study, Xiang et al. (2016) had done a randomized controlled trial at 14 centers in china for the safety and efficacy of a cardiac pacemaker. Cardiac arrhythmia is a noteworthy clinical issue prompting significant grimness and mortality. As indicated by the insights of American Heart Association, the occurrence of bradyarrhythmia was accounted for to be 4%. It is assessed to influence 5.6 12.0 million individuals in 2050 and will prompt more than 400,000 yearly sudden heart deaths in the United States. Implantation a cardiovascular pacemaker is the best path for treating patients with bradyarrhythmia. In the previous decades, heart pacemakers have spared a huge number of patients experiencing cardiovascular bradyarrhythmia and have enhanced the personal satisfaction of patients. They collected the parameters of the pacemaker systems immediately after the implantation of the device. A 6-month follow-up for the pacing rate was being recorded. Electrical properties, single- pole and double-pole polarity conversion, magnet response, adverse events and rate response function of the pacing system were analyzed. For measuring the primary qualitative result Chi-square test, Wilcoxon signed-rank test and paired t-test were used (Weiss et al. 2013). The outcomes were analyzed and compared for achieving the results of the distributed measurement data. Safety evaluations were directed by recording all-causes of deaths, pacemaker-related antagonistic occasions and cardiovascular deaths within six months of implantation. In addition, the clinical side effects, essential signs (circulatory strain and heart rate), and research center parameters were checked. In the event that irregular changes were noticed, their relationship with the pacemaker was examined. Research facility parameters included finish blood check, liver capacity, renal capacity, and blood coagulating tests (Bailey et al. 2015). In the third study of Reddy et al. (2015), it has been described that every year, around 1 million individuals everywhere throughout the world get standard transvenous cardiovascular pacemakers with dynamic fixation prompts treat bradycardia and heart piece. Despite huge mechanical types of progress as the introduction of the pacemakers before six decades, antagonistic events related to pacemaker occurring in 1 out of 10 patients. The events are consistently related to surgical pocket, the transvenous lead, or pulse generator. These leads are weak and easily, breaks or insurance dissatisfaction and can in like manner causes polluting, cardiovascular gap, venous obstruction, and tricuspid regurgitating forward. Pulse generators are being connected with ailment, stash hematoma, and skin breaking down. As of late a gadget is being produced that is totally autonomous, leadless cardiovascular pacemaker with joined battery, equipment, and terminals. Through the femoral vein, the catheter is inserted and the leadless heart pacemaker is non-surgically placed inside the right ventricle. Wiping out the device takes and transvenous lead furthermore conceivably restricts some whole deal bothers saw with customary pacemakers, for instance, tricuspid valvular heaving forward and thrombo-embolism over a patent foramen ovale (Durrani et al. 2016). Achievability of the leadless heart pacemaker in individuals was showed up in the LEADLESS trial. A nonrandomized trial was finished reviewing the clinical security and sufficiency of nonsurgical implantation of the Nanostim leadless cardiovascular pacemaker in patients who require interminable ventricular pacing. The arranged examination, that was reported here, incorporates the essential investigation of viability and wellbeing in the underlying 300 patients who were taken after for a half year (the essential companion) and results for every one of the 526 patients who were enlisted as of June 2015 (the aggregate partner). A global directing board of trustees, with the investment of the support, was in charge of the outline and lead of the investigation and the revealing of the discoveries. Observing and accumulation of the information and introductory information examinations were performed by the support in organization with the guiding council (Bailey, Gleva and Woodard 2015). Patients were rejected on the off chance that they had mechanical tricuspid-valve prosthesis, pneumonic blood vessel hypertension, prior endocardial pacing or defibrillation leads, or a substandard vena cava channel or in the event that they had experienced cardiovascular or fringe vascular surgery inside 30 days before enlistment. The essential result investigation was a prespecified evaluation of the essential viability and wellbeing end focuses in the initial 300 patients who were taken after for a half year. The composite essential viability end point was both a restoratively adequate pacing catch edge (2.0 V at 0.4 msec) and remedially worthy detecting sufficiency (R wave 5.0 mV, or an esteem equivalent to or more noteworthy than the incentive at implantation) through a half year. The essential wellbeing end point was flexibility from gadget related genuine unfavorable occasions amid the underlying a half year after implantation (Falk et al. 2017). Every single antagonistic occasion were mediated by an autonomous clinical-occasions board of trustees. A genuine antagonistic occasion was characterized as any untoward restorative event that prompted passing or to a genuine disintegration in the soundness of a patient that brought about hazardous ailment or damage, perpetual impedance of a body structure or a body capacity, inpatient or delayed hospitalization, or a therapeutic or surgical mediation to counteract perilous sickness or damage or changeless weakness to a body structure or a body work. Genuine unfavorable occasions were named gadget related on the off chance that they were considered by the clinical-occasions board to be owing to the investigational gadget or methodology (Lee et al. 2014). The cohort study was assessed for all non gadget related genuine unfriendly occasions amid a half year of development. Such occasions were thought to be random to the investigational gadget or method. Since the LEADLESS II trial is progressing, auxiliary examinations were performed on information from extra patients who were enlisted as of June 2015, joined with information from the initial 300 patients, who had broadened follow-up past a half year (add up to companion) (Figure 2). Extra investigations in the aggregate associate included assurance of all gadgets related and nongadget related genuine antagonistic occasions amid development and the impact of administrator encounter (Miller et al. 2015). It has been evaluated that if 300 patients were taken after for a half year, the examination would have 90% power, at a two-sided 5.0% importance level, to demonstrate rates of security and viability that would be better than foreordained execution objectives for wellbeing and adequacy. The execution objective for the essential viability end purpose of both a restoratively adequate pacing catch limit and a remedially satisfactory detecting sufficiency through a half year was 85%, and the investigation was fueled under the supposition that the rate of this end point would be 91.5% or higher. The execution objective for adequacy depended on a continuous pacemaker contemplates that is supported by St. Jude Medical (Phillips 2015). The execution objective for the essential wellbeing end purpose of flexibility from gadget related genuine unfriendly occasions through a half year was 86%, and the investigation was fueled under the presumption that the occasion free rate would be 92%. The ou tcomes demonstrate that pacemaker implantation was effective in 504 of the 526 patients (95.8%). Most patients (70.2%) did not require gadget repositioning after starting sending. The term of healing facility remain from implantation to release was 1.11.7 days (run, 0 to 33) (Ritter et al. 2015). Conclusion Thus from the above discussion, we can get an idea about pacemaker and the importance of its use. A pacemaker is a device which is very small in size and is placed in the chest or abdomen. The modern days pacemakers are a bigger improvement as compared to the earlier models, as the circuit models have become much smaller. The pacemaker helps for monitoring and control the heartbeat. Most pacemakers are extremely solid and agreeable. They're a bit small than a normal matchbox and weigh around 20 to 50 grams. A pacemaker is placed simply under your neckline bone and will have at least one leads which are set into your heart through a vein. References Foster, A.J., Tockman, B.A., Liu, L., Simms Jr, H.D. and Bustillos, A.M., Cardiac Pacemakers, Inc., 2017. Implantable medical devices with separate fixation mechanism. U.S. Patent 9,694,172. 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