ShantanuT01/DACTYL-Pretraining huggingface dataset:
Introduction The present paper aims at discussing the case of Dierdre, an 80-year-old female. The patient fell in the car park after a morning swims in a heated swimming pool. Dierdre had obviously damaged her collarbone, as she experienced 4/10 pain in the area at rest and 10/10 at movement or palpation. Her right collarbone was deformed with redness and swelling. Her arm had limited movement, and the sensation in her fingers was reduced. Among other abnormalities, the patient seemed to experience hypothermia (body temperature 35°C). The patient was given a blanket to increase body temperature. No other traumas or abnormalities were found during the assessment. Management Plan Clinical Approach to Assessment The purpose of the assessment is to confirm or reject the diagnosis and identify possible comorbidities and associated traumas. The clinical assessment also helps to identify the most appropriate treatment strategy and referrals. In the present case, collarbone fracture is to be suspected due to the obvious history of trauma, pain, and swelling in the area of the right collarbone, and limited movement of the right arm. When assessing patients with clavicle fractures, it is crucial to conduct both physical examination and radiographic assessment. Physical examination should include pain, deformity, vascular, neurologic, respiratory, and mediastinal contents assessments (1). First, patients with collarbone fractures experience focal pain (1). Second, deformity needs to be assessed for obvious displacement, motion, or crepitus (1). Third, the arm needs to be compared to the healthy one in terms of vascular status, and any sign of arterial injury should be investigated (1). Fourth, the neurological assessment of the brachial plexus should also be assessed by comparing it to the contralateral side (1). Finally, respiratory function and injury to the esophagus, trachea, or great vessels should also be assessed (1). Radiographic assessment is also crucial for acquiring a detailed view of the damaged area. The appropriate X-ray views include upright anteroposterior (AP) clavicle view, Zanca view, serendipity view, and AP chest views if concerns about pneumothorax arise (1). CT scans may also be needed for medial clavicle fractures or if there is concern about arterial injuries (1). In rare cases, EMG may be required with brachial plexus injuries (1). However, the majority of cases are diagnosed with X-rays only. Pain Management Options Pre-hospital pain management is crucial for improving patient outcomes. Pain management for paramedics, however, is not merely providing pharmacological treatment. Paris and Phrampus (2) claim that pain management is to be based on SPLINT
Throughout this course, we explored readings that have not only expanded our vision into the world of individuals, but also the different ways in which people view the world. The different authors we have studied have given us the opportunity to take a peek into the struggles that people are facing and the ways in which certain characters become disconnected from the world. We have also been able to look at the ways in which individuals in the society develop the skills that enable them to deal with their problems. It has been possible for us to observe that characters from various cultural background and with different upbringing struggle with the same issues which, in some ways, are interconnected. The texts have enabled us to visualize the indirect ways in which individuals are interlaced with each other’s lives as well as the ways in which they can be connected. The readings have also exposed the reasons explaining why family members and people who have grown up together cannot understand what one of them is going through. Perhaps, this is because they do not share certain variables that help shape their identity and worldviews. Though one may judge the other, this judgment is often done without being aware of what influences the thoughts of that individual. There are moments when the authors of some stories make us want to reach out and interact with the protagonists and show them the mistakes they inflict on themselves. We see how some characters are scared of facing the reality that awaits them and, as a reaction, preclude themselves from the others and society and box themselves into a world where they can feel safe and protected. We also see how some individuals interact with the people who surround them in building a kinship that gives them the strength to face the reality. They can open the doors into a world that they have not seen before. In this essay, we will explore the different stories where the characters struggle to deal with their lives or have accepted life as a failure, or fight to face reality. We will explore the ways in which the interconnections between people can either benefit some characters or hurt the others. It will be established that reaching out to some people can sometimes help them find out something they have been unaware of. We will also show how relations can save lives in some cases and in others, how they destroy them. In some of these stories, we come across the characters scared to face the problems, or overwhelmed by the difficulties in their lives. Such individuals choose to box themselves in an imaginable place where they can feel free and create a world of their own. This is the world in which they are the creators as well as the managers, and can, therefore, maintain control over their lives. However, we are often made aware that by doing so, they inflict pain on themselves by convincing themselves that this lie is real and the only means of securing their emotions is by having a distraction. In Missing , the woman feels the pain of desertio
Introduction In 1788, the United States of America adopted its first constitution, which has however undergone several amendments over the years. Among the many amendments made on the constitution of the United States of America is the famous 17 th Amendment. The 17 th Amendment was passed in two stages, first by the Senate on June 12, 1911 and later the House passed the same amendment on May 13, 1912. In the following year on 8 th April, the amendment was ratified and later put on election in 1914. The 17 th Amendment was meant to amend Article one of Section 3 of the constitution, which initially provided that the Senators be elected by state legislature (Kochan 1023). The amendment now provided that the election of the Senators be done by the people such that the people from every state are allowed to elect their own Senators instead of having them directly appointed by the state legislature. However just like most of the other amendments and laws, the 17 th Amendment faced both critics and supporters of the same. Most of the critics of this amendment claimed that it led to the loss of the State’s representation in the election of the Senators. On the other hand, those who supported the amendment claimed that it gave the persons on the ground to elect their own leaders. This paper is therefore an exploration of the 17 th Amendment to determine its impact on the government and the entire United States of America. To achieve this, the paper will discuss the expected key institutional changes and reasons as to why the direct elections have not transformed the Senate into a more majoritarian institution in the way that the House is. The expected key institutional changes The 17 th Amendment can be said to have affected the way Senators are elected among other changes in the House by a great deal. As such, the 17 th Amendment of the constitution of the United States provides an opportunity to explore the institutional effects of the House representations. This is attributed to the way it changed the way Senators in the United States are elected by making them accountable to the state voters instead of the state legislature. This issue led to the 17 th Amendment being accepted in some states, while a few of the states rejected it. Nevertheless, despite the reception that the amendment got from different states, it had to be implemented. The implementation of the 17 th Amendment brought along several key institutional changes to be discussed in this section. Just as most critics of the 17 th Amendment argue, it is ag
Abstract An investment policy statement has been devised for an investor who has a high-risk tolerance. A brief analysis of Saudi Arabia’s debt market has been conducted which shows that the market is in the early stages of development. Based on the investment policy statement and the market analysis, five growth-oriented stocks have been selected from Tadawul Index which is the only stock exchange in Saudi Arabia. Daily return data has been collected for the stocks as well as the Tadawul Index for the last six months. Based on the collected data, expected returns and CAPM returns of the selected stocks have been calculated. Security Market Line has also been drawn based on the expected returns of the stocks. The study shows that CAPM and Security Market Line can help to identify undervalued stocks. Based on the analysis, recommendations have been given for the concerned investor. Long-term investment has been recommended for value stocks and short-term restricted investment has been recommended for growth stocks. Policy Statement The investor is an unmarried 26-year-old college graduate who has recently started a career in banking. The investor has no serious health conditions and no significant need to support his parents who have their own retirement income. The time horizon of the investor has two milestones. The first milestone will be 15 years later when the investor will face significant requirements of funds to finance the college education of children. The second milestone will be around 33 years later when the investor will retire and require income to live comfortably. Based on the age, willingness and risk profile of the investor, it has been determined that the investor has high-risk tolerance. The current goal of the investor should be capital appreciation. It is recommended to invest 85% of total capital into equities, 10% into debt securities, and 5% into cash for any sudden capital needs. Saudi Debt Capital Market The Saudi debt market has three types of fixed income securities. The first type is an asset-based corporate Sukuk which is equivalent to a bond in Islamic Finance. In an asset-based Sukuk, returns from the Sukuk are dependent on returns from a particular asset but the investors do not have direct recourse to the asset in case of a default. Sukuks tend to have variable rates of return since the returns are linked to the performance of the underlying asset. The second type is a usual corporate bond that offers fixed returns in addition to the interbank rate SIBOR. The third type is a sovereign bond which is issued by the government. The first sovereign Islamic bond was issued by the Saudi government in 2012 (Hamdan, 2012). The Saudi debt market is still very isolated since foreign investors are not allowed to invest in local issues. Moreover, most Sukuk and bond issues are short term hence there is no active yield curve beyond five years. Howeve
Introduction Administration of anesthesia on patients undergoing surgery started in the early 1840s and gained a lot of impact in 1946 when William Morton used ether on gilbert as anesthesia at Massachusetts hospital in Boston. Before its discovery, surgery was very agonizing and was only done as a last resort to save a life. The efficiency of a surgeon then was determined by his or her speed as many patients did not survive the agony experienced because they used alcohol and morphine to reduce the pain. Latter, chloroform was used but caused liver damage in spite of its good work and popularity. Today anesthesia has achieved objectives like causing patients to get asleep faster and in a pleasant process, as well as the development of local anesthesia. Nowadays, surgeons have enough time to be more accurate, especially on complex procedures. They are also well trained, and anesthesia is very safe, with an estimated number of 1 death in 250,000. (Bankert, 2005 pp 23-35). Role of early anesthetists Catherine S. Lawrence became the first nurse to provide anesthesia with the assistance of other nurses during the civil war between 1861 to 1865, but just a little of the medicine was administered as it was considered too unsafe. However, Sister Mary Bernard was the first nurse to be officially recognized in1878 when she was practicing as a nun at St. Vincent’s Hospital. The roles of the early anesthetists were to find out if the patient was fit for the process and gave the framework for a professional assessment. They did all the tests required ahead of the surgery and checked the outcomes of the screening. They also explained the effects of anesthesia to the patients for them to make the final decision. (Thatcher, 2004 pp 4550). Anesthesia leaders Alicia Magaw and Sister Mary Bernard Alicia Magaw became the most popular anesthetist and was recognized as the mother of anesthesia of the 19 th century because of her effectiveness in her work, especially in the use of open-drop inhalation using ether and also because of the publishing of her research. However, the earliest records regarding the care of anesthesia patients showed the works of Sis
Although over the years of nursing practice, family intervention in the process of treatment has been recognized as a mandatory attribute, the scope of the family’s influence on the patient has been significantly modified. Previously, family health was related solely to the qualitative indicator of health conditions of the individuals within a unit. Today’s interpretation of the term encompasses the peculiarities of communication and mental influence (Wampler & McWey, 2020). Thus, it would be safe to assume that the concept of family health is of paramount importance for medical practice. Indeed, as soon as patients leave hospital premises, their treatment process continues at home, with family members being responsible for both psychological and physical support. In order to ensure satisfactory rates of family health and mutual health maintaining, Barnes et al. (2020) suggest some of the following strategies:   * Partnership. As family members frequently feel left out in terms of the treatment process, they tend to avoid further responsibility at home in order to avoid negative outcomes. However, when the family believes that the patient’s well-being is as dependent on their actions as on the actions of practitioners, it may be more willing to take action in ensuring family health improvement.   * Education. Nurses, as public health educators, should provide family members and close surroundings with exhaustive information about how the well-being of each of them may be directly affected by the family’s treatment and attitude. In order to choose an efficient strategy, nurses are to communicate with the patient on the matter of their interaction with the family. After gaining proper information, the nurse obtains a better perspective in terms of the family’s perception of family health. As a result, medical workers have the ability to define where to start the educational process in order to secure a gradual yet efficient framework of family health promotion and therapy system.
Ansel Adams and John Sexton are now widely recognized by many critics as landmark figures in the history of American and world photography. Their main masterpieces demonstrate that this type of visual art cannot be reduced to mere emulation of life and the surrounding world; more likely, it is a powerful means of self-expression or even rendering one’s emotions and feelings. They also show that a photographer must possess good technical skills and a prodigious sense of timing to detect and capture the ephemeral moment; without these properties, he or she is rather unlikely to succeed. Furthermore, imagination and sensitivity are not sufficient for success because photography also demands a scientific approach that enables to render most precise details. This paper aims to compare and contrast such works as LA Freeway 1 by Ansel Adams and Stream Turbine Detail 2 by John Sexton. These photographs have been selected because they allow us to draw parallels between the style of these artists, their vision, and their techniques. First, it is necessary to pay attention to such criteria as the themes explored by the authors, how they convey their ideas to the viewer. Secondly, it is vital to examine the use of shades and contrast; we need to identify the purpose for employing a certain artistic technique. Finally, the comparative analysis of these works should incorporate other photographs made by Adams and Sexton. The thing is that these examples ( LA Freeway and Stream Turbine Detail) that we are going to study represent only a small part of their vast heritage. Although there might be immense dissimilarities between Adams and Sexton, we may say their pictures explain the key challenges that a photographer has to face. First and foremost, it should be pointed out that Ansel Adams and John Sexton were acquainted with one another: Sexton was Adams assistant and student for a very long time, more than five years (Bidner & Wegner, 92). Most importantly, he was immensely influenced by his teacher. In particular, we should speak about Adams Zone System, developed to measure and estimate exposure (Spaulding, 132). This approach gives a good opportunity to visualize future photographs with almost mathematical accuracy. Currently, this method enjoys immense popularity among photographers throughout the world. As his student, John Sexton immensely relies on this method in his works. It should be borne in mind that in his youth Sexton gave preference to color photography, yet when he saw Adams works he decided to switch black-and-white pictures (Bidner & Wegner, 92). So, in part, these facts prove that their artistic styles may be reminiscent of one another. At first glance, one may even suppose that Sexton is just a faithful follower of A
Concept definition The theory of attribution is mainly concerned with the analysis of causes and the causal inferences, i.e. the perceived reasons of events. Weiner’s theory of attribution argues that the emotions that people experience from a situation or an event are determined by the perceived causes of these events, where two emotions can be distinguished, attribution-depe
As the target market size is huge comprise more than 50% of the population of Latin America, so the objective would be to sell a large number of units at comparatively less price. However, it is suggested that before the full launch of the product, the market should be extensively researched and calculated in term of volume and value, so that the strategy evolved could be more successful and forecasting errors can be avoided. Furthermore, the new brand should have some kind of innovation so that it appears different from the competition. In other words, its positioning should convey the message of clear benefit to the customer because our target market is very much prudent about the cost and quality of the brand. Following is the recommended marketing mix for this new brand. Price: As Unilever is targeting a low-income market and it has already a brand ( camper ) in the market, which also focuses on cost reductions, so I think, there exists a potential danger of cannibalization. Therefore, it is suggested that a new name should be introduced, having less price than a camper , many be in the range of 1$ to 1.5$, but with better quality in terms of cleanliness. The major competitor brand will be “ pop ” of P&G and “ invicto” by ASA. To compete with these brands, Unilever has to focus on the value of the product i.e. delivering more benefits than the price paid for it. Promotion: For targeting this market, the promotional mix should be such that it could easily target the market and the cost-effective as well. At the launch of the product, Unilever should go for below-the-line activities (BTL). In the beginning, it should introduce some schemes like giving free samples, discounts in terms of quantity, money-saving incentives, coupons, and personal selling, etc. These activities should be backed up by advertising on the radio, newspaper, and local TV channels. It shou
The Blackfeet reservation possesses some unique beauty but under it, there are valuable resources, like oil that is sealed inside the tight shale approximated to be thousands of feet under the ground (Healy). The exercise has split the tribe leading to emergence of a debate over the capacity and abilities of hydraulic fracturing and fracking. The debate comes as a result of ideological differences as many of the residents even view the land as sacred and symbol of life that should not be interfered with. The group opposing the whole practice argues that the land acts as a tourist attraction site thus a source of foreign exchange and subsequently source of income to the government and the residents respectively (Rosier 56). They say their lifeline is dependent on the land. Contrary, those supporting the practice respond that since recession hits the globe, the number of tourists has significantly fallen thus the land has become more of a liability than the asset as it was before (Healy). On job creation, it is approximated that 49 job vacancies could be created in a single drilling rig (Rosier 56). The tribes’ men that support this move said that this was a method of wealth creation and that their land would soon be independent and stable thus being free from external intervention (Bryan 115). Economists in the region explain that the fracking process is very economical to the tribe compared to other methods but it is alleged that this will only be in the short run as the dangers in the long run will exceed the benefits (Okon 89). As the oil rigs were being constructed, others argued that the tribe was making an irreversible mistake that would in the long term come to haunt the whole community. Blackfeet tribal’s business council newly elected member, Cheryl Little Dog, was heard saying that the mountains belonged to the tribe as a whole and should not be ruined at the expense of oil rigs (Healy). Environmentalists within the area argue that if fracking operations are to continue, then everybody within and outside the region is going to suffer as the air will be continuously contaminated. Watersheds considered to be sensitive could also be contaminated in the process (Grinnell 118). Not only had the sacredness of the land that concerns the opposing side but also the acute consequences that are to be faced (Healy). They say that they have always faced terrific problems in the past but presently they have a chance of facing somehow the most intimidating challenge: an environmental degradation (Rosier 40). Such pollutions of the air and water are always a hazard to the environment and those who live within it have to note that their health is at risk (Healy). Experts demonstrate that not only is the process of fracking makes wells contaminated but also brings about house explosion. The opponents of the idea argue that even their animals are at risk. Fracking is also anticipated to cause earth movements like earthquakes, which have always been a great hazard worldwide (Okon 56). It is argued by some group of conserv