Petroleum Resources and the Economy of Angola Essay

Petroleum Resources and the Economy of Angola - Essay Example In this literature review this issue is studied taking a look at the conflictive positions regarding the "resource curse" that have been taken by different researchers along the years. We have to keep in mind that any kind of resource can't be a curse in itself as it is logical to assume. Everything depends on the use we give to a specific resource. In this line of thought it is obvious that ultimately the effects of petroleum resources on a nation have to be positive. Indeed they should be a blessing rather than a curse as we will see in this literature review. "Even until the mid-(1950s), coal was still the world's foremost fuel, but oil quickly took over. Following the 1973 energy crisis and the 1979 energy crisis, there was significant media coverage of oil supply levels. This brought to light the concern that oil is a limited resource that will eventually run out, at least as an economically viable energy source." (Wikipedia, 2006i). Petroleum is a finite resource, and besides this fact there are some negative environmental side effects that are valid reasons to discourage its use as the Ecology Center argue among other important facts about petroleum. Let's see: "No corner of the world is left untouched by the effects of petroleum ex... Many negative effects are well documented, such as global warming, habitat destruction, and political conflicts over oil supplies. But the petroleum economy extends its often hidden reach into many other aspects of life on our planet. Petroleum, used for transportation, industry, and mechanized agriculture, is the backbone of globalization. Institutions of global trade, such as the World Trade Organization (WTO), work hand in hand with oil companies, while militaries provide the armed backup to protect these interests." (Ecology Center, 2003). The position of Ocean Engineering and Energy Systems (OCEES) favors Ocean Thermal Energy Conversion (OTEC) as an alternative fuel produced by the power of the sea. OCEES points out the negative effects of wars as detrimental environmental consequence of the political conflicts around oil control (OCEES International, n. d.). One relevant aspect to be considered about the finiteness of petroleum resources is the "oil peak" established by the Hubbert Peak Theory regarding the terminal depletion of all petroleum resources. The Wikipedia states the following about the oil peak and its practical consequences. "Given past oil production data and barring extraneous factors such as lack of demand, the model predicts the date of maximum oil production output for an oil field, multiple oil fields, or an entire region. This maximum output point is referred to as the peak. The period after the peak is referred to as depletion. The graph of the rate of oil production for an individual oil field over time follows a bell-shaped curve: first, a slow steady increase of production; then, a sharp increase; then, a plateau (the "peak"); and, finally, a steep decline." (Wikipedia, 2006f). Even though the Hubbert Peak Theory has faced

Marketing Planning Essay Example | Topics and Well Written Essays - 2500 words

Marketing Planning - Essay Example 256). In an effective way to overcome, this particular barrier, the top management should be actively involved in the process of marketing planning. Continuous update of the planning process also needs to be provided to them at regular intervals. Lack of line Support Hostility and non co operation on the part of the functional as well as divisional managers and personnel of the organization regarding the implementation of the newly designed marketing planning process is another factor that has to be taken into account in this case. It can be said that in order to overcome this particular barrier, the managers of the respective functions and division has to be increasingly convinced about how the effectiveness of the new process of marketing planning will lead to the process of better value proposition for the customers and thereby will promote significant growth of the company. Failure of in depth analysis The failure to conduct an in-depth analysis of the capability of the resources available to the company is another reason that can lead to the process of failure of marketing planning. To overcome this particular barrier, an internal audit has to be carried out by the company which will increasingly focus on the process of highlighting the resource capability and its probable effective utilization by the company. Lack of Synchronization The lack of proper co-ordination and synchronization between the departments of marketing and production of the company can also emerge as a barrier to effective marketing planning. In an attempt to overcome this particular barrier, it can be said that the application of an information system throughout the organization will be highly relevant. The application of the information system throughout the company will lead to the process of eradication of this particular barrier by significantly promoting a common platform which will promote synchronization of the marketing and production department. Regard Marketing Consultant. 4b . Strategic Planning process is a very important activity for any business organization (Simerson, 2011, p.1). It is a key factor in the business in regards to strategic management, which enables the company to provide directions, guidelines and boundaries to the functional and operational processes of an organization (Steiner, 1997, p.4). It can be increasingly said that the entire process of strategic planning is intended to focus on the forward progress of the business through the process of market development, product development as well as achieving significant share of the market and growth in revenue. The presence of a large number of macro factors that can bring a significant range of impact in the firm’s area of business environment leads to the process of providing a significant level of importance to the strategic planning process of the firm. It can be said that the strategic planning process undertaken by various business organizations helps them to prepare for t he impending uncertainties lingering in the business environment and thereby prepare backup plans and options, which will empower them to avoid complete disruption of the firms’ business processes. On the other side, it can be said that the marketing planning process enables the marketing teams of organization to focus on the processes of generation, communication, distribution and capture of values from the target audience, while

Critical Issue Promoting Technology Use In Schools Education Essay

Critical Issue Promoting Technology Use In Schools Education Essay Although there has been a strong push to get educational technology into the hands of teachers and students, many obstacles to implementation still exist. Equipment may not be placed in easily accessible locations. Hardware and software often pose problems for teachers in the classroom, and just-in-time technical support may be unavailable. Teachers may lack the time and the motivation to learn technology skills. Professional development activities may not provide ongoing, hands-on training for teachers or practical strategies for implementing technology into lesson plans. Initial technology funding may not be sustained and thus not capable of providing upgrades, maintenance, and ongoing professional development. Fortunately, these obstacles can be addressed and overcome. This Critical Issue provides practical information for promoting technology use in schools. OVERVIEW: The push to provide technology in schools has been successful in recent years. According to Goldman, Cole, and Syer (2000), most schools have computer labs and many have computers in every classroom. More than 90 percent of all schools are connected to the Internet, and more than 33 percent of teachers have Internet access in their classrooms. Yet teachers readily admit that they are not making as much use of technology as they could. According to an Education Week survey, nearly 30 percent of teachers said their students use computers only one hour per week; nearly 40 percent said their students do not use computers in the classroom at all (Trotter, 2001). Although technology is more prevalent in the schools, several factors affect whether and how it is used. Those factors include placement of computers for equitable access, technical support, effective goals for technology use, new roles for teachers, time for ongoing professional development, appropriate coaching of teac hers at different skill levels, teacher incentives for use, availability of educational software, and sustained funding for technology. Placing Computers for Equitable Access Access to technology is an important issue for teachers and students. Although schools may have computers available, one factor that determines their use is where those computers are located. If computers are connected to the Internet but are not in a convenient location, the availability to students and teachers will be limited. Across the case study sites, there were five different strategies for allocating computers for student use:  · Distribution among the regular classrooms  · Computers in labs  · Mobile computer labs  · Incremental roll-out  · School-within-a-school The standard computer lab is commonly used in schools. If the use of the computer lab is carefully scheduled, it will provide high equipment utilization; on the other hand, keeping the computers in one place may be a barrier to using them on a continual but intermittent basis as a part of the curriculum. Some schools prefer to place computers in the regular classroom. These computers often are distributed through incremental rollout. In incremental rollout, technology is given to a limited number of classrooms at first and then expanded to an additional classroom each year. Sometimes the computers are distributed on a grade-by-grade basis with primary grades first and upper grades later receiving the most up-to-date equipment. This approach requires continual, yearly funding. Some schools have chosen to start with their Internet connection in the school library. This location necessitates that the library-media specialist is aware of educational sites to supplement students classroom activities. The library-media specialist also needs to work with teachers and the technology specialist to determine the best use of the equipment. In situations where software also is a limited commodity, the school library may house and catalog the software, as is done with other educational materials. This situation makes the software available to all teachers and allows teachers flexibility in assigning work to students. Whatever decisions are made on allocation of equipment, it is imperative that all staff members are included in the decision making and that long-term plans are made for acquisition and upgrading of materials. Such collaborative decision making and planning helps ensure staff buy-in, equity of access, and effective use of technology in teaching and learning. Providing Technical Support Without continuous technical support, technology integration in the classroom will never be satisfactorily achieved (Bailey Pownell, 2002). Most teachers have heard horror stories about equipment failure, software complexity, data loss, embarrassments, and frustration. They dont want to be left hanging with 30 students wondering why nothing is working the way it is supposed to be. When teachers are trying to use technology in their classrooms and they encounter difficulties, they need immediate help and support. Providing Time for Ongoing Professional Development Learning the new roles and ways of teaching that go hand-in-hand with technology integration requires that teachers have opportunities to participate in an extended process of professional development. Teachers need time to acquire technology skills and develop new teaching strategies for integrating technology into the classroom. Except for occasional in-service programs, teachers often have no time built into the school day for their own professional development. When professional development activities are conducted after school, teachers may not have the energy necessary for engaging in learning. Burgos (2001) notes, The research on staff development tells us that its least effective when its done at the end of the school day. Some researchers suggest that the ideal time for teachers to participate in professional development activities is during the summer, when students are not a consideration and teachers do not have as many demands on their time. But teachers are more likely to apply new instructional strategies if they receive feedback and support while trying the new strategies in their classrooms. Coaching Teachers at Different Skill Levels A school may be home to educators with a wide variety of skill levels in technology: computer gurus anxious to put the capabilities of the newest hardware and software to use; moderate technocrats, who implement basic computerized tasks; and the technologically limited. The problem faced by administrators and professional development staff of such a school is providing adequate training to bring all teachers to an adequate level of technical expertise so learning goals can be met. After the teachers skill levels are identified, administrators, teachers, and the technology specialist can brainstorm to determine what support and resources teachers need to advance to the next stage. Teachers can develop personal plans for professional development that include goals for using technology. These professional development plans can be competency driven, identifying specific areas where technology can be used effectively; they can specify outcomes to be achieved using technology, such as implementing specific projects with students; and they can list software applications that should be mastered by specific dates. By putting individual goals in writing, these plans formalize teachers commitment to using technology in the classroom, states Tenbusch (2002). Choosing Appropriate Software One barrier to technology integration is the difficulty many teachers face in finding and using appropriate software for instruction (Glenn, 2003). Teachers at novice or apprenticeship stages of technology integration may need guidance in locating multimedia software and Internet sites to support the schools learning goals, either because they are unfamiliar with these media or because they feel overwhelmed by the profusion of software on the market and sites on the Internet. Lack of time and experience to make good decisions about what particular products or sites have the potential of fostering learning goals can make technology integration a frightening prospect. Glenn (2003) succinctly summarizes the challenge: Problems exist with finding and using appropriate software or courseware for instruction. The number of high-quality curriculum materials has increased, and there is a wider variety; however, creating innovative learning opportunities for all students remains a fundamental challenge and elusive for far too many teachers. GOALS:  · The schools technology plan clearly identifies learning goals to be achieved through technology.  · Technology supports the instructional learning goals. It is integrated into instruction in meaningful ways so that it contributes to the attainment of high standards by all students.  · Technology is used for challenging, long-term projects that promote students higher-order thinking skills instead of merely for drill-and-practice programs to improve basic skills.  · All students have opportunities to use a variety of technologies to support their work on authentic tasks.  · All technology is in operable condition and is being used effectively and to the maximum extent possible.  · Just-in-time technology support is available for teachers and students.  · There is a flexibility in managing the technology to ensure that all students and teachers have equity of access.  · Professional development is considered an important part of the technology plan and the technology budget.  · The professional development component of the technology plan ensures that every teacher has allotted time throughout the school year for professional development relating to technology and its integration into the classroom.  · Professional development in technology is directly applicable to the classroom situation.  · A diverse portfolio is in place to ensure that funding is available to support technology and ongoing professional development. Administrators:  · Pursue funding strategies to provide the necessary technology, professional development, technical support, equipment upgrades, and equipment maintenance to achieve educational goals.  · Develop strategies for ensuring equitable use of education technology for all students and teachers.  · Acknowledge the benefits of plugging educators into technology improved student performance, increased student motivation, lower student absenteeism, and higher teacher morale.  · Understand the implications of preparing teachers for the Digital Age.  · Ensure that the school is providing professional development for effective technology use.  · Determine expectations for teachers in regard to their use of technology in their classrooms. Develop strategies for teaching the teachers and eventually winning teachers over.  · Read about technology implementation strategies in Teachers and Technology: Making the Connection.  · Provide all teachers and administrators with an Internet e-mail address. Use e-mail for all school announcements.  · Provide a networked computer on the desk of every teacher and administrator.  · Provide all teachers with on-site training in technology use. Ensure that teachers have adequate time to practice new skills, explore software, and become proficient with the schools technology.  · Involve teachers in identifying and pursuing technology professional development that is appropriate to their needs and skills.  · Encourage teachers to set their own technology integration goals as part of their individual professional development plans.  · Ensure that adequate technical support is available.  · Address any problems that arise with new uses of technology in the classroom quickly and efficiently.  · Use a variety of time and monetary incentives as well as job requirements that encourage teachers to use technology in their classrooms. o Provide release time for teachers to participate in technology professional development activities during the school day. o Pay for additional professional development activities, such as outside conferences and workshops that address specific classroom technology issues. o Pay teachers to act as technology mentors for teachers with novice technology skills. o Provide classroom-embedded mentoring, tutoring, and follow-up activities. o Financially reward teachers for designing good instructional uses of technology. o As an additional incentive, offer technology for classroom or personal use: laptop computers, technology equipment, and software. o Make teachers base pay contingent upon participation of technology professional development. o Include technological competence as one aspect of teacher evaluation. o Tie job security to technology professional development by adding technology competence to teacher evaluation, requiring technology-related professional development for contract renewal, or making technology professional development a requirement for re-certification.  · Periodically visit classrooms to determine teachers technology needs and to observe and encourage their integration strategies.  · Provide opportunities for teachers to observe effective technology use in other classes or schools.  · Recognize teacher successes with technology. Share these stories with the school and the community. Encourage teachers to share their successes with colleagues at conferences.  · Participate in professional development programs, study groups, and other technology activities with teachers and other staff members.

Marriage: Easy Divorce :: essays research papers

Marriage: Easy Divorce   Ã‚  Ã‚  Ã‚  Ã‚  Although I do not agree with getting married until you are positive that you want to have a huge commitment to another person, I favor the easier divorce. I think that a divorce is not really anyone's fault. (unless it is) The divorce should be done as quickly as possible in either case.   Ã‚  Ã‚  Ã‚  Ã‚  If you find yourself getting married to the person that you thought you loved-but later on in life you find that you weren't ready for marriage, then it's not really anyone's fault. You may have made a mistake by getting married to quickly, but people make mistakes.   Ã‚  Ã‚  Ã‚  Ã‚  Sometimes, you may find that your spouse and you make better friends than husband and wife. That could happen and I'm sure it's probably already happened once or twice. In this case, it is not really anyone's fault. You just go on with life just as you always had before.   Ã‚  Ã‚  Ã‚  Ã‚  I think that people shouldn't get married until they are totally positive that their spouse is the person that they want to have a lifetime commitment with. If they even think twice, then they are not ready for marriage. I know that not everyone will feel the same way that I do on this subject, but if everyone did, it could improve the divorce rate. I think that we should just get the divorce over with as quickly as possible and get to living our lives again.   Ã‚  Ã‚  Ã‚  Ã‚  I know someone's dad who got into a relationship with another woman. This person's mother got married at a very young age. She thought she was ready, but she wasn't. After being married and having three children, her husband told

Choledocholithiasis

Choledocholithiasis (which called bile duct stones or gall bladder stones in the bile duct) is the presence of stones from gall bladder in the common bile duct. Stones usually form in gall bladder but they sometimes pass through the cystic duct into common bile duct. There are many symptoms of gallstone in common bile duct. For example; abdominal pain (in the right upper or middle upper abdomen), fever, jaundice (yellowing of the skin and eyes), loss of appetite, nausea and vomiting and clay-colored stools.) Healthline, 2016) So, this condition diagnosed and treated by ERCP. ERCP (Endoscopic retrograde cholangiopancreatography) is a procedure that enables doctor to examine the pancreatic and bile ducts by insert lighted tube which called endoscope (like the thickness of your index finger) is placed through the mouth and into stomach and first part of the small intestine (duodenum) exactly in (ampulla) and passed of cannula (which a small plastic tube) through the endoscope and into this opening with injected contrast material and X-rays are taken to study the common bile duct. (Suissa et al., 2018) (Turk, 2011) Fluoroscopy is a radiographic procedure that provides a dynamic image of the inside of the body frequently after the administration of the contrast media with the use of persistent x-ray beam that passes through the area of interest and later the attenuated beam that come out of the patient is received by a video monitor to view the body part motion in details. The fluoroscopic studies can efficiently detect variety of abnormalities of different body systems such as the skeletal, digestive, cardiovascular, respiratory, reproductive and urinary system. (University of Rochester Medical Center,2018). In this assignment I will discuss about equipment used in ERCP, role of radiographer in ERCP, technical and exposure consideration of ERCP and case study. ?ERCP Equipment ERCP contain endoscopy and fluoroscopy. Fluoroscopy consists of C-arm and monitor. Endoscopy consist of flexible tube which called endoscope with at the end it contain a tiny video camera and light. There is a canal inside components of the scope through which thin instruments are passed and can be poked out the tube's end. These instruments include a catheter, balloon, basket, sphincterotome, biopsy forceps and cytology brush and stents. So, for injecting contrast media into the ducts by used of catheter. Used of balloon is to stretch tight areas of the bile duct or pancreatic duct. Also, for removing and manipulating stones used of basket, and to incise tissue and make the bile duct or pancreatic duct opening larger used of a sphincterotome. Biopsy forceps and cytology brush use to obtain microscopic exam, and use stent to bridge blockages. Other openings allow the doctor to suck out water or air inside digestive system as well as clean the camera lens. Control the movement of the tube by gently pushing and pulling on its outside end is done by the doctor while also steering the inside end with control knobs that the doctor holds in his hand. Video television screen in the procedure room is received images from the endoscope. Also, obtain an x-ray image of the bile duct and pancreatic duct by the fluoroscopy. (ASGA, 2016).Role of Radiographer in ERCP:Before examination: First, asked to remove any clothing or jewelry that may get in the way of the body area to be examined and wear gown. Then, check name and an identification number of the patient. Third, prepare the C-arm machine and the monitor. Fourth, positioned on the x-ray table depending on what the doctor want. Fifth, make sure everyone who stays in ERCP room wear lead apron. (ASGA, 2016). During examination: Regarding on department's equipment, radiographer may have to stay out in the control panel or may be able to stand in the room to x-ray. stand in the room to x-ray In the latter, it is important to pay close attention so as not to miss cue to x-ray.The doctor will ask the radiographer to x-ray when it is required if screen or spot. Also, the radiographer be attention for doctor and patient condition. (ASGA, 2016).After examination:The radiographer save the image and sent it. Make sure the machine is clean. (ASGA, 2016).Technical of ERCP: Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that to diagnose and treat diseases regarding to the pancreatobiliary system by used of endoscopy and fluoroscopic imaging. The endoscopic portion of the examination uses endoscope that is passed through the esophagus and stomach and into the second portion of the duodenum. For obtaining high-quality radiographic images and for the prevention of pulmonary aspiration and considered optimal for cannulation of the papilla, so ERCP is performed with the patient in the prone position. But, patients who can not able for prone position for ERCP are often placed in the left lateral decubitus or supine positions. ( Malas, 2017) Radiation exposure consideration of ERCP: In ERCP the fluoroscopy time is shorter when ERCP is performed by doctor who has many years experience of done ERCP and carried out a large number of ERCPs in the past year. In general, radiation exposure is higher during therapeutic ERCP than during diagnostic ERCP. Radiation dose to patients during ERCP depends on many factors, and the doctor unable to control some variables which are patient size, procedure type, or fluoroscopic equipment used. In a recent prospective study where ERCP instruments used for example, stent insertion, lithotripsy, needle-knife, biopsies, the use of a guide wire or additional wires other than the standard, a balloon and catheter, that will significantly increase fluoroscopy duration. (Boix and Lorenzo-Zà ºÃƒ ±iga, 2011)Patient preparation and care: Before the examination, the stomach should be empty. The patient who does the ERCP must not eat anything after midnight on the evening before the exam. Regarding for examination time, if the procedure is done early in the morning, no drinks must be taken, but if examination is done at noon time, a cup of tea, juice, milk, or coffee can be taken four hours earlier. medications of heart and blood pressure must always be taken with a little amount of water in the early morning. The patient needs to have a companion drive them home after the procedure, since the procedure will require intravenous sedation. (Jay and Marks, 2018) To cause relaxation and sleepiness, the patient will be given medications through a vein. Local anesthetic is given to the patient to decrease the gag reflex. Some doctors prefer to give the patients more intravenous medications for sedation, so do not use local anesthetic. This also applies to those patients who cannot tolerate the bitter taste of the local anesthetic or who have a history of allergy to xylocaine and the numbness sensation in the throat. The intravenous medication is given, while the patient is lying on the left side on the X-ray table, and then the instrument is inserted gently through the mouth into the duodenum. The instrument advances through the food passage and not the air passage. It does not interfere with the breathing and gagging is usually prevented or decreased by the medication. After the examination, patients must be observed in the recovery place until most of the effects from the medications have worn off. This sometimes takes one to two hours. (Jay and Marks, 2018) Case study: This case study is about 77 years old female patient with H/O common bile duct stones. The condition start 8 months ago by right upper abdominal pain and clay colored stools. The patient came to Royal Hospital and the doctor decided to take x-ray first. So, they found 3 large stones in common bile duct. Then the doctor decided to do ERCP. The ERCP was done in 7/5/2018. The doctor saw a perimapullary diverticulum and with injected contrast through common bile duct, the cholangiogram showed 3 large stones proximally back to back, the balloon was used to remove the stones. However, this patient was uncooperative, so stenting done in long time with use 9cm plastic biliary stent with good bile drainage. (Royal, 2018) Conclusion: Overall, ERCP is procedure to examine different diseases regarding to biliary system. One of these conditions is choledocholithiasis which is stone in gallbladder or common bile duct. ERCP can diagnose and treat choledocholithiasis. ERCP used fluoroscopy to examine the endoscope inside the patient, so radiographer is one of most important member in ERCP room. Also, ERCP used endoscope insert through the mouth into stomach with insert some instrument inside its canal. Technique of insertion endoscope with lower radiation dose for the experienced endoscopists, patient and who stay in ERCP room. Nowadays, ERCP is most common done in world, so most of the people know about it. Choledocholithiasis Choledocholithiasis (which called bile duct stones or gall bladder stones in the bile duct) is the presence of stones from gall bladder in the common bile duct. Stones usually form in gall bladder but they sometimes pass through the cystic duct into common bile duct. There are many symptoms of gallstone in common bile duct. For example; abdominal pain (in the right upper or middle upper abdomen), fever, jaundice (yellowing of the skin and eyes), loss of appetite, nausea and vomiting and clay-colored stools.) Healthline, 2016) So, this condition diagnosed and treated by ERCP. ERCP (Endoscopic retrograde cholangiopancreatography) is a procedure that enables doctor to examine the pancreatic and bile ducts by insert lighted tube which called endoscope (like the thickness of your index finger) is placed through the mouth and into stomach and first part of the small intestine (duodenum) exactly in (ampulla) and passed of cannula (which a small plastic tube) through the endoscope and into this opening with injected contrast material and X-rays are taken to study the common bile duct. (SAGES, 2018) Fluoroscopy is a radiographic procedure that provides a dynamic image of the inside of the body frequently after the administration of the contrast media with the use of persistent x-ray beam that passes through the area of interest and later the attenuated beam that come out of the patient is received by a video monitor to view the body part motion in details. The fluoroscopic studies can efficiently detect variety of abnormalities of different body systems such as the skeletal, digestive, cardiovascular, respiratory, reproductive and urinary system. (University of Rochester Medical Center,2018).In this assignment I will discuss about equipment used in ERCP, role of radiographer in ERCP, technical and exposure consideration of ERCP and case study. ? ERCP Equipment ERCP contain endoscopy and fluoroscopy. Fluoroscopy consists of C-arm and monitor. Endoscopy consist of flexible tube which called endoscope with at the end it contain a tiny video camera and light. There is a canal inside components of the scope through which thin instruments are passed and can be poked out the tube's end. These instruments include a catheter, balloon, basket, sphincterotome, biopsy forceps and cytology brush and stents. So, for injecting contrast media into the ducts by used of catheter. Used of balloon is to stretch tight areas of the bile duct or pancreatic duct. Also, for removing and manipulating stones used of basket, and to incise tissue and make the bile duct or pancreatic duct opening larger used of a sphincterotome. Biopsy forceps and cytology brush use to obtain microscopic exam, and use stent to bridge blockages. Other openings allow the doctor to suck out water or air inside digestive system as well as clean the camera lens. Control the movement of the tube by gently pushing and pulling on its outside end is done by the doctor while also steering the inside end with control knobs that the doctor holds in his hand. Video television screen in the procedure room is received images from the endoscope. Also, obtain an x-ray image of the bile duct and pancreatic duct by the fluoroscopy. (University et al., 2018)Role of Radiographer in ERCP:Before examination:First, asked to remove any clothing or jewelry that may get in the way of the body area to be examined and wear gown. Then, check name and an identification number of the patient. Third, prepare the C-arm machine and the monitor. Fourth, positioned on the x-ray table depending on what the doctor want. Fifth, make sure everyone who stays in ERCP room wear lead apron.During examination:Regarding on department's equipment, radiographer may have to stay out in the control panel or may be able to stand in the room to x-ray. stand in the room to x-ray In the latter, it is important to pay close attention so as not to miss cue to x-ray. The doctor will ask the radiographer to x-ray when it is required if screen or spot. Also, the radiographer be attention for doctor and patient condition.After examination:The radiographer save the image and sent it. Make sure the machine is clean. Technical of ERCP:Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that to diagnose and treat diseases regarding to the pancreatobiliary system by used of endoscopy and fluoroscopic imaging. The endoscopic portion of the examination uses endoscope that is passed through the esophagus and stomach and into the second portion of the duodenum. For obtaining high-quality radiographic images and for the prevention of pulmonary aspiration and considered optimal for cannulation of the papilla, so ERCP is performed with the patient in the prone position. But, patients who can not able for prone position for ERCP are often placed in the left lateral decubitus or supine positions. ( Malas, 2017) Radiation exposure consideration of ERCP:In ERCP the fluoroscopy time is shorter when ERCP is performed by doctor who has many years experience of done ERCP and carried out a large number of ERCPs in the past year. In general, radiation exposure is higher during therapeutic ERCP than during diagnostic ERCP. Radiation dose to patients during ERCP depends on many factors, and the doctor unable to control some variables which are patient size, procedure type, or fluoroscopic equipment used. In a recent prospective study where ERCP instruments used for example, stent insertion, lithotripsy, needle-knife, biopsies, the use of a guide wire or additional wires other than the standard, a balloon and catheter, that will significantly increase fluoroscopy duration. (Boix and Lorenzo-Zà ºÃƒ ±iga, 2011) Patient preparation and care:Before the examination, the stomach should be empty. The patient who does the ERCP must not eat anything after midnight on the evening before the exam. Regarding for examination time, if the procedure is done early in the morning, no drinks must be taken, but if examination is done at noon time, a cup of tea, juice, milk, or coffee can be taken four hours earlier. medications of heart and blood pressure must always be taken with a little amount of water in the early morning. The patient needs to have a companion drive them home after the procedure, since the procedure will require intravenous sedation. (Jay and Marks, 2018)To cause relaxation and sleepiness, the patient will be given medications through a vein. Local anesthetic is given to the patient to decrease the gag reflex. Some doctors prefer to give the patients more intravenous medications for sedation, so do not use local anesthetic. This also applies to those patients who cannot tolerate the bitter taste of the local anesthetic or who have a history of allergy to xylocaine and the numbness sensation in the throat. The intravenous medication is given, while the patient is lying on the left side on the X-ray table, and then the instrument is inserted gently through the mouth into the duodenum. The instrument advances through the food passage and not the air passage. It does not interfere with the breathing and gagging is usually prevented or decreased by the medication. After the examination, patients must be observed in the recovery place until most of the effects from the medications have worn off. This sometimes takes one to two hours. (Jay and Marks, 2018)Case study:This case study is about 77 years old female patient with H/O common bile duct stones. The condition start 8 months ago by right upper abdominal pain and clay colored stools. The patient came to Royal Hospital and the doctor decided to take x-ray first. So, they found 3 large stones in common bile duct. Then the doctor decided to do ERCP. The ERCP was done in 7/5/2018. The doctor saw a perimapullary diverticulum and with injected contrast through common bile duct, the cholangiogram showed 3 large stones proximally back to back, the balloon was used to remove the stones. However, this patient was uncooperative, so stenting done in long time with use 9cm plastic biliary stent with good bile drainage. (Royal, 2018)Conclusion:Overall, ERCP is procedure to examine different diseases regarding to biliary system. One of these conditions is choledocholithiasis which is stone in gallbladder or common bile duct. ERCP can diagnose and treat choledocholithiasis. ERCP used fluoroscopy to examine the endoscope inside the patient, so radiographer is one of most important member in ERCP room. Also, ERCP used endoscope insert through the mouth into stomach with insert some instrument inside its canal. Technique of insertion endoscope with lower radiation dose for the experienced endoscopists, patient and who stay in ERCP room. Nowadays, ERCP is most common done in world, so most of the people know about it. Choledocholithiasis Choledocholithiasis is one common disease in common bile duct. It defined as stones found it in biliary tree by usually formed in gall bladder. The bile drainage from gall bladder through the bile duct to the intestine. The location of gall bladder is under the liver and the shape of it is like a pear. The place of these stones either stay in gall bladder or go to common bile duct. The patient who has this disease, may feel one or some of these symptom like; abdominal pain which exactly felt in middle or right upper abdomen, fever or jaundice (mean yellowish color in eye and skin). Also, loss appetite, nausea, vomiting or clay colored stools. ) Healthline, 2016) So, this condition diagnosed and treated by ERCP. ERCP stands for endoscopic retrograde cholangiopancreatrography. The definition of ERCP is a minor operation done by the doctor to examine biliary tree with insert lighted tube which called endoscope, so it is placed in second part of duodenum exactly in ampulla through the mouth into esophagus and stomach. The size of endoscope is similar to index finger size. At the site of endoscope in ampulla, the cannula passes through the endoscope and into this hollow with injected contrast media and the fluoroscopy taken by the radiographer to study the common bile duct. (Suissa et al., 2018) (Turk, 2011) Fluoroscopy is a radiographic procedure that provides a dynamic image of the inside of the body frequently after the administration of the contrast media with the use of persistent x-ray beam that passes through the area of interest and later the attenuated beam that come out of the patient is received by a video monitor to view the body part motion in details. The fluoroscopic studies can efficiently detect variety of abnormalities of different body systems such as the skeletal, digestive, cardiovascular, respiratory, reproductive and urinary system. (University of Rochester Medical Center,2018). In this assignment I will discuss about equipment used in ERCP, role of radiographer in ERCP, technical and exposure consideration of ERCP and case study. ? ERCP Equipment ERCP contain endoscopy and fluoroscopy. Fluoroscopy consists of C-arm and monitor. Endoscopy consist of flexible tube which called endoscope with at the end it contain a tiny video camera and light. There is a canal inside components of the scope through which thin instruments are passed and can be poked out the tube's end. These instruments include a catheter, balloon, basket, sphincterotome, biopsy forceps and cytology brush and stents. So, for injecting contrast media into the ducts by used of catheter. Used of balloon is to stretch tight areas of the bile duct or pancreatic duct. Also, for removing and manipulating stones used of basket, and to incise tissue and make the bile duct or pancreatic duct opening larger used of a sphincterotome. Biopsy forceps and cytology brush use to obtain microscopic exam, and use stent to bridge blockages. Other openings allow the doctor to suck out water or air inside digestive system as well as clean the camera lens. Control the movement of the tube by gently pushing and pulling on its outside end is done by the doctor while also steering the inside end with control knobs that the doctor holds in his hand. Video television screen in the procedure room is received images from the endoscope. Also, obtain an x-ray image of the bile duct and pancreatic duct by the fluoroscopy. (ASGA, 2016).Role of Radiographer in ERCP:Before examination: First, asked to remove any clothing or jewelry that may get in the way of the body area to be examined and wear gown. Then, check name and an identification number of the patient. Third, prepare the C-arm machine and the monitor. Fourth, positioned on the x-ray table depending on what the doctor want. Fifth, make sure everyone who stays in ERCP room wear lead apron. (ASGA, 2016).During examination: Regarding on department's equipment, radiographer may have to stay out in the control panel or may be able to stand in the room to x-ray. stand in the room to x-ray In the latter, it is important to pay close attention so as not to miss cue to x-ray. The doctor will ask the radiographer to x-ray when it is required if screen or spot. Also, the radiographer be attention for doctor and patient condition. (ASGA, 2016).After examination:The radiographer save the image and sent it. Make sure the machine is clean. (ASGA, 2016). Technical of ERCP: Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that to diagnose and treat diseases regarding to the pancreatobiliary system by used of endoscopy and fluoroscopic imaging. The endoscopic portion of the examination uses endoscope that is passed through the esophagus and stomach and into the second portion of the duodenum. For obtaining high-quality radiographic images and for the prevention of pulmonary aspiration and considered optimal for cannulation of the papilla, so ERCP is performed with the patient in the prone position. But, patients who can not able for prone position for ERCP are often placed in the left lateral decubitus or supine positions. ( Malas, 2017) Radiation exposure consideration of ERCP: In ERCP the fluoroscopy time is shorter when ERCP is performed by doctor who has many years experience of done ERCP and carried out a large number of ERCPs in the past year. In general, radiation exposure is higher during therapeutic ERCP than during diagnostic ERCP. Radiation dose to patients during ERCP depends on many factors, and the doctor unable to control some variables which are patient size, procedure type, or fluoroscopic equipment used. In a recent prospective study where ERCP instruments used for example, stent insertion, lithotripsy, needle-knife, biopsies, the use of a guide wire or additional wires other than the standard, a balloon and catheter, that will significantly increase fluoroscopy duration. (Boix and Lorenzo-Zà ºÃƒ ±iga, 2011) Patient preparation and care: Before the examination, the stomach should be empty. The patient who does the ERCP must not eat anything after midnight on the evening before the exam. Regarding for examination time, if the procedure is done early in the morning, no drinks must be taken, but if examination is done at noon time, a cup of tea, juice, milk, or coffee can be taken four hours earlier. medications of heart and blood pressure must always be taken with a little amount of water in the early morning. The patient needs to have a companion drive them home after the procedure, since the procedure will require intravenous sedation. (Jay and Marks, 2018) To cause relaxation and sleepiness, the patient will be given medications through a vein. Local anesthetic is given to the patient to decrease the gag reflex. Some doctors prefer to give the patients more intravenous medications for sedation, so do not use local anesthetic. This also applies to those patients who cannot tolerate the bitter taste of the local anesthetic or who have a history of allergy to xylocaine and the numbness sensation in the throat. The intravenous medication is given, while the patient is lying on the left side on the X-ray table, and then the instrument is inserted gently through the mouth into the duodenum. The instrument advances through the food passage and not the air passage. It does not interfere with the breathing and gagging is usually prevented or decreased by the medication. After the examination, patients must be observed in the recovery place until most of the effects from the medications have worn off. This sometimes takes one to two hours. (Jay and Marks, 2018)Case study: This case study is about 77 years old female patient with H/O common bile duct stones. The condition start 8 months ago by right upper abdominal pain and clay colored stools. The patient came to Royal Hospital and the doctor decided to take x-ray first. So, they found 3 large stones in common bile duct. Then the doctor decided to do ERCP. The ERCP was done in 7/5/2018. The doctor saw a perimapullary diverticulum and with injected contrast through common bile duct, the cholangiogram showed 3 large stones proximally back to back, the balloon was used to remove the stones. However, this patient was uncooperative, so stenting done in long time with use 9cm plastic biliary stent with good bile drainage. (Royal, 2018) Conclusion: Overall, ERCP is procedure to examine different diseases regarding to biliary system. One of these conditions is choledocholithiasis which is stone in gallbladder or common bile duct. ERCP can diagnose and treat choledocholithiasis. ERCP used fluoroscopy to examine the endoscope inside the patient, so radiographer is one of most important member in ERCP room. Also, ERCP used endoscope insert through the mouth into stomach with insert some instrument inside its canal. Technique of insertion endoscope with lower radiation dose for the experienced endoscopists, patient and who stay in ERCP room. Nowadays, ERCP is most common done in world, so most of the people know about it.

Psychodynamic Personality Theories Essay

Contemporary society is intrigued with the notion of human behavior as it expresses itself in our personality. Psychoanalytic model is most noted for introspective strategies such as depth interviewing and projective techniques, which have emanated from its theoretical perspective. Classical psychoanalytic conceptualization approached the study of character or personality in two very different ways, each deriving from an early theoretical model of individual development. In the era of Freud’s original drive theory, an attempt was made to understand personality on the basis of fixation. Later with the development of ego psychology, character was conceived as expressing the operation of particular styles of defense. This second way of understanding character was not in conflict with the first; it provided a different set of ideas and metaphors for comprehending what was meant by a type of personality (Magnavita, 2002). The contemporary psychodynamic model of personality is very popular, particularly with clinical practitioners, and offers much that is useful for conceptualizing personality and personal disorders. The strength of this model seems to lie in the power of many of its fundamental constructs, such as the unconscious, defense systems, and the relation among component personality structures. It is hard to imagine a psychology of personality without some reference to these and other constructs. The limitations of this model are many. Unfortunately, after years of perpetuating itself in a closed system, a crisis developed about the viability of this model. Another draw back is the tendency to eschew empirical research, which would have established wider scientific acceptance. For many, the conceptualizations and esoteric language make it difficult to immerse oneself in what seems a dogmatic intellectualized system for those who hide behind language. In conclusion knowing where to approximately place an individual on the structural continuum is as much a clinical art as a science. Reference Magnavita, J. J. (2002). Theories of personality: contemporary approaches to the science of personality. New York: John Wiley and Sons.