Dehydration of Methylcyclohexanol Essay Example for Free

Dehydration of Methylcyclohexanol Essay A common Sophomore Organic Chemistry laboratory experiment that has great potential for further research is the acid catalyzed dehydration of simple alcohols. The classic dehydration of 2-methylcyclohexanol experiment that was introduced in Journal of Chemical Education in 1967 Taber(1967)JCE:44,p620. The rather simple procedure of distilling an alcohol with an aqueous acid has spawned several investigations that have resulted in formal journal articles. At the same time, the experiment has retained its popularity in the Sophomore Organic Chemistry laboratory curriculum. In one line of inquiry it has been observed that a mixture of 2-methylcyclohexanol diastereomers gives rise to a mixture of three isomeric alkenes Todd(1994)JCE:71,p440; Feigenbaum(1987) JCE:64, p273; Cawley (1997) JCE:74l, p102. Explaining the presence of the three alkene products requires an intense synthesis of information communicated in a typical SOC textbook. The continued popularity of this experiment is corroborated by the observation that Googling the phrase â€Å"Dehydration of 2-Methylcyclohexanol† on January 13th, 2008 returned no less than 20 hits for online student handouts and/or guides for this SOC laboratory experiment. Moreover, this experiment provides fertile ground for experimentation and innovation that has not yet been fully explored. At Dominican University, the SOC students performed this experiment during the Fall 2007 semester with not only the dehydration of 2-methylcyclohexanol (Aldrich 153087) but also the 4-methyl (Aldrich 153095) and 3-methyl (Aldrich 139734) positional isomers. The reaction products were submitted to GC-FID analysis. As predicted from the Journal of Chemical Education articles, three methylcyclohexene products were observed. Their relative abundance measured by peak height was 80, 16, and 4%. The alkene products represented by these peaks apparently correspond to 1-methycyclehexene, 3-methycyclehexene, and methylenecyclohexane respectively. [pic] The dehydration of 4-methylcyclohexanol produce two products, that can be distinguished by our current GC column, at 90 and 10% with retention times that match 3-methycyclehexene and 1-methycyclehexene respectively. My current theory is that the retention times 3 and 4-methycyclohexene could not be distinguished with GC column and temperature program. However, there is still the issue of how 1-methycyclehexene is produced from 4-methylcyclohexanol. [pic] The dehydration of 3-methylcyclohexanol yields two products, that can be distinguished by our current GC column, at 80 and 20% with retention times that match 3-methylcyclohexene and 1-methycyclehexene respectively. [pic] Samples of 1-methyl and 3-methyl cyclohexenes purchased from Aldrich chemical confirmed two of compound assignments for the dehydration of 2-methylcyclohexanol. Obviously, it remains to separate the 3 and 4-methylcyclohexene by GC. There are several advantages of studying the dehydration of methylcyclohexanols in the first semester of Organic Chemistry: 1) The experiment involves reactions that are typically studied during first semester: E1, E2, and the 1,2-hydride shift. It is a time-tested protocol that has been run in hundreds of labs by thousands of students. 2) Analysis of the experiment involves the understanding of all three mechanisms mentioned previously and how they may compete with each other. In other words, it is a simple experiment that demands a rather involved interpretation of results. 3) It shows that textbooks â€Å"rules† such as the Zaitzev’s rule in this case, are not necessarily rules as such, but rather astute observations of general trends that can vary experimentally depending on the reactant and the reaction conditions. 4) Analytically, we are observing/measuring the presence of 3 known methylcyclohexene and methylenecyclohexane products that can be separated and detected by Gas Chromatography. I believe that the product mixtures can also be analyzed by NMR. 5) The reaction lends itself to an inquiry format that involves the study different reactants and reaction conditions on the ratio of products. In fact, this experiment, in my opinion, is an ideal candidate for a multi-institution collaborative study that combines and interprets student data. want to pursue point #5 further by first grappling with the current literature concerning the â€Å"Evelyn Effect.† The JCE article by David Todd, â€Å"The Dehydration of 2-Methylcyclohexanol Revisited: The Evelyn Effect† observes a kinetic effect that can be explained by proposing that in a mixture of cis/trans 2-Methylcyclohexanol the cis isomer reacts much faster than the trans isomer to give predominately 1-methylcyclohexene. The formation of 1-methylcyclohexene from cis-2-methylcyclohexanol would involve an â€Å"E2-like† anti-elimination of proton and the protonated alcohol. The dehydration of the trans isomer would go through a E1 mechanism that requires the formation of a carbocation before elimination of a proton. A follow-up study by Cawley and Linder: â€Å"The Acid Catalyzed Dehydration of an Isomeric 2-Methylcyclohexanol Mixture† involves a detailed kinetic study. Students began with a 36.6/63.4 cis/trans mixture of 2-methylcyclohexanol with a cyclohexanol impurity (% impurity was not reported). They performed thy typical reaction+distillation and collected fractions at 4, 8, 16, 24, and 28 minutes. They also collected a 0.1 mL volume of the sample of the reaction mixture at each of these time intervals. These fractions were analyzed by 1H NMR and GC for composition. The cis/trans rate constants for the dehydration of reaction were determined to be 8.4/1.0 – much less than 30/1 ratio reported in 1931 by Vavon and Barbier. An intriguing study! It would be very interesting to have the raw (student) data on this one. Very little is said about the product ratios in the distillate fractions, they just report that they obtained 2.1% methylenecyclohexane and not the 4% previously reported. The dehydration of methylcyclohexanols provides a fecund problem to explore. The key is to develop methods to determine the distribution of alkene products in terms of % total alkenes. There are four possible positional isomers: I. methylenecyclohexane (Aldrich, Acros, 1192-37-6); II. racemic 3-methyl-1-cyclohexene (Acros, 591-48-0); III. 1-methyl-1-cyclohexene (Aldrich, Acros 591-49-1) IV. racemic 4-methyl-1-cyclohexene (Aldrich, Acros 591-47-9). Two of the alkene positional isomers contain an asymmetric carbon. The obvious place to start is by studying how the alcohol structure affects the product distribution of alkenes. There are 5 positional isomers of methylcyclohexanol: I. cyclohexanemethanol (Aldrich 100-49-2); II. 1-methylcyclohexanol (Aldrich 590-67-0); III. racemic cistrans 2-methylcyclohexanol (Aldrich 583-59-5) IV. racemic cistrans 3-methylcyclohexanol (Aldrich 591-23-1) V. cistrans 4-methylcyclohexanol (Aldrich 589-91-3). Three of the alcohols are present in cis and trans diastereomer pairs: cis 2-methylcyclohexanol (Aldrich 7445-70-1) trans 2-methylcyclohexanol (Aldrich 7445-52-9) cis 3-methylcyclohexanol (5454-79-5) trans 3-methylcyclohexanol (7443-55-2) cis 4-methylcyclohexanol (Aldrich 7731-28-4) trans 4-methylcyclohexanol (Aldrich 7731-28-4). In addition there are 4 entaniomer pairs among the alcohol starting materials. Most of them are commercially available, for a price. [pic] Besides the structure of the alcohol, what other variables may be explored? 1) One variable for this reaction that could be investigated is the nature of the catalytic acid. Aqueous acids, such as the 85% H3PO4 typically used for this experiment, contain some water which is also product of the reaction. I may also add that, the amount of acid is not always in catalytic proportion to the substrate. In my current protocol 0.075 moles of acid is used to dehydrate 0.2 moles of alcohol. Non-aqueous acids may give different results. Acidic resins are an interesting substitute for aqueous acids. For example, John Ludeman and Kurt Field of Bradley University presented a poster at the 2006 ACS Great Lakes Regional Meeting on the use of Dowex 50WX2-100, Amberlite IRC-50S, and Amberlyst 15, for the dehydration of alcohols. 2) Another variable would be the reaction conditions. In the current paradigm, the alkene is distilled away from the reaction mixture. Presumably, it is being distilled away as it is formed. An ad-hoc observation is that students seem to get somewhat different product ratios if they distill is carefully or if they â€Å"crank up the heat† and distill it quicker. What if the reaction mixture was refluxed to equilibrium before distillation? Would we see more thermodynamic products? 3) Reaction conditions could be changed in other ways too. Microwave irradiation is currently being explored as an alternative to heating reactions. Possibly, sonication could also be performed on the alcohol. 4) Another avenue to explore may be different strategies to push the reaction towards the products other than distilling off the alkene. For example, removing water with molecular sieves may be tried. The last installment of this series will explore the logistics of â€Å"dehydration of methylcycohexanols† as a collaborative experiments. The most straightforward collaboration would be to perform the â€Å"dehydration of methylcycohexanols† experiment in the same way and compare the relative yield of alkenes as measured by GC from different starting alcohols. Comparisons could be made with past data or concurrently collected data from different institutions. This may be seem fairly straightforward, but there will most likely be discrepancies that could will need to be explored. One aspect to make note of would be the source and composition of the methylcyclohexanols used a starting materials. Sigma-Aldrich has †¢ 1-methylcyclohexanol #M38214; †¢ 2-methylcyclohexanol #66320, #215295, #178829, #24113, #153087, †¢ 3-methylcyclohexanol #139734; †¢ 4-methylcyclohexanol #66360, #104183, #104191, #153095; †¢ as well as just plain methylcyclohexanol #66370. An experimental variable that is hard to control is rate of heating. Students who crank up the hot plate to get done quickly (even though they were told not to) may get different results than those students who go slowly and maintain an even temperature. Different GC columns and methods may also give results that need to be corroborated.

Types of Behaviors Essay Example for Free

Types of Behaviors Essay Description: In this assignment, you will apply the principles of classical and operant conditioning, as well as the notions derived from cognitive explanations of learning. You will write a paper on one of two types of behaviors that can be readily explained from a learning perspective. Using a Microsoft Word document, write a 500- to 750-word paper that explains the development of one of the following behaviors. (Be sure to specify the behavior you are discussing in your paper.) *Fear-driven reactions to insects *Cigarette smoking *Aggression For the chosen behavior, use the models of learning to explain how the behavior may develop and be maintained, so that it seems to occur automatically. Learning is the only perspective considered so do not attempt to use other explanations (i.e., the psychodynamic or biological approach) in your answer. When preparing your paper, consider the following questions: * How might classical conditioning principles apply to the origins of the behavior and maintenance of it? Clearly indicate what the unconditioned and conditioned stimuli are in your answer. * How might the principles of reinforcement discussed in operant conditioning apply to the behavior? Don’t forget that reinforcement can be either positive or negative in nature. * How do cognitive principles apply to the behavior? Specifically consider Albert Bandura`s ideas regarding imitational learning. Your paper should be well-written, original, free of grammar and spelling errors, and follow APA format.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Behavior can be defined as the sum total of all the actions and reactions performed by an individual in a given circumstance or situation in the environment.   Aggression is a behavior intended to cause harm or pain to others or the self.   It may be in the form a physical action or verbal.   The models of learning attempt to describe the manner in which an individual learns a particular behavior.   Some of the models of learning through which an individual develops aggressive behavior include classical conditioning, operant conditioning and social learning theory.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Classical conditioning was a model of learning defined by Pavlov following his studies on dogs.   Pavlov found that when dogs were shown food their salivation increased (Braslau-Schneck, S., 1998).   Food in this case was an unconditioned stimulus that produced an unconditioned response (salivation) (Braslau-Schneck, S., 1998).   He then repeatedly presented a stimulus to the dogs which was slowly associated with food (such as footsteps).   Slowly the dogs began to associate the footsteps (which after constant repetition became a conditioned stimulus) and began to produce a conditioned response (salivation). In this way several other emotions such as fear and aggression can be conditioned in an individual (Braslau-Schneck, S., 1998).   In the famous JB Watson’s experiment over little Albert, Watson initially presented a loud sound (unconditioned stimulus) that made the body frightened and cry (unconditioned response) due to fear.   He then presented two stimuli simultaneously, that is a rat and a loud sound.   Over a period of time the boy began to associate the rat with the loud sound.   The rat with repetition became a conditioned reflex producing a conditioned response (symptoms of fear). A good instance of this with relevance to aggression includes presentation of an artificial hand that snatches away the food whilst a hungry dog is eating.   The dog would exhibit an aggressive reflex (such as barking which is an unconditioned response) to the artificial hand (unconditioned stimulus).   The dog is then presented a high-frequency sound (audible only to dogs followed) by the appearance of the hand.   Following repetitions, the dog would bark (conditioned response) after it hears the high-frequency sound (conditioned stimulus), and would not wait until it is presented with the unconditioned stimulus.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   According to Skinner’s operant theory, the individual when performing an action in the environment, experiences a stimulus (that encourages or discourages such behavior) which will directly affect the performance of such actions again in the environment.   It consists of a action and the results.   If positive reinforcement occurs following the action, the individual will perform the similar action again in the environment, and will also increase its frequency (Boeree, G. C., 1998).    However, if the action is followed by an aversive stimulus or negative reinforcement, there will be reduced chances of performing the same behavior in the future.   A good example of aversive stimuli is punishment, which can follow several aggressive acts.   Rigorous imprisonment can be pronounced for several criminal activities so that it can act as a negative reinforcement.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Albert Bandura discovered the ‘social learning theory of behavior’ (Isom, M. D., 1998).   He considered that aggressive behavior is usually learned through a process known as ‘behavior modeling’, which can occur in different ways (especially by observing elders perform in case of children) (Isom, M. D., 1998).   A child may become aggressive and certain reinforcements may be experienced such as financial gains, rewards, praises from parents, reduction in internal stress, etc.   Parents and family members were often considered as models by the children, and acts performed by them were likely to be imitated.   The child will only perform the action of its model if the model was successful or is rewarded.    A classical experiment to demonstrate the social learning theory is the famous Bobo doll experiments in which the children observed elders attacking a doll, and later imitated the action of the elders.   This type of observational learning was known as ‘modeling’.   Children who have a tendency to demonstrate aggressive behavior should be identified immediately in order to prevent aggressive behavior and criminal activity, later in life (Isom, M. D., 1998). Bandura’s theory was comparable to Skinner’s theory because observational learning (as the child would learn only the actions that were successful or were being rewarded) is similar to a positive reinforcement.   An individual is most likely to learn criminal behavior during the adolescent stage.   Children tend to follow the actions of the same sex parents (Bjorkqvist, K., 1997).   Studies have shown that children who tend to watch TV (especially those programs that show violence) are at a higher risk of demonstrating aggressive behavior later in life. References: Bjorkqvist, K. (1997). Learning aggression from Models: from a social Learning toward a Cognitive theory of Modeling. In Feshbach, S., Zagrodzka, J. (Ed), Aggression: Biological, Developmental, and Social Perspectives, New York: Plenum Press. http://www.vasa.abo.fi/svf/up/articles/Learning_Aggression_From_Models.PDF Boeree, G. C. (1998). Albert Bandura: Personality Theory. Retrieved December 26, 2006, From Shippensburg University Web site: http://www.ship.edu/~cgboeree/bandura.html Boeree, G. C. (1998). B. F. Skinner: Personality Theory. Retrieved December 26, 2006, From Shippensburg University Web site: http://www.ship.edu/%7Ecgboeree/skinner.html    Braslau-Schneck, S. (1998). An Animal Trainers Introduction to Operant and Classical Conditioning. Retrieved December 26, 2006, Stacys Wag and Train   Web site: http://www.wagntrain.com/OC/ Isom, M. D. (1998).   The Social Learning Theory. Retrieved December 26, 2006, FSU College of Criminology and Criminal Justice Web site: http://www.criminology.fsu.edu/crimtheory/bandura.htm

Peak Expiratory Flow Rate (PEFR) in Lung Diseases

Peak Expiratory Flow Rate (PEFR) in Lung Diseases PEFR value means peak expiratory flow rate that is a persons maximum speed of expiration. It can be measured by peak flow meter which is a simple device. People can use it monitoring their lung function in respiratory diseases. As a lung function test, it can be differentiated obstructive airway diseases such as asthma, COPD(chronic obstructive pulmonary diseases) from restrictive lung diseases. PEFR is mostly used to diagnosis asthma. Normal PEFR value depends on several factors like age, sex, height, weight, etc. So the PEFR value varies with normal individuals and a Nomo gram is utilized as a scale. In obstructive airways diseases, normal value of PEFR is reduced corresponding to above factors. As above factors, though PEFR value has some advantages, to diagnose obstructive airway diseases it cant differentiate asthma from COPD. Lung function tests, What is PEFR and how can we measure it, Importance in PEFR value in lung diseases have been included in this analytical essay. Lung Function Test Measurements of respiratory function may provide valuable information. First, in conjunction with the clinical assessment and other investigations they may help establish a diagnosis (1). Second, they will help indicate the severity of the condition. Third, serial measurements over time will show changes indicating disease progression or, alternatively, a favorable response to treatment. Finally, regular monitoring of lung function in chronic diseases such as idiopathic pulmonary fibrosis, cystic fibrosis or obstructive airways disease may warn of deterioration (1). Simple respiratory function tests fall into three main groups: Measuring the size of the lungs Measuring how easily air flows into and out of the airways Measuring how efficient the lungs are in the process of gas exchange (1). Pulmonary function can be measured by having a subject breathe into a device called a spirometer which recapture the expired breath and records such variables as the rate and depth of breathing, speed of expiration, and rate of oxygen consumption (2). The spirometer measures the FEV1 and the forced vital capacity (FVC). Both the FEV1 and FVC are related to height, age and sex. The technique involves a maximum inspiration followed by a forced expiration (for as long as possible) into the spirometer (3). The act of expiration triggers the moving record chart, which measures volume against time. Patients with severe airflow limitation may have a very prolonged forced expiratory time (3). At home asthma patient and others can monitor their respiratory function by blowing into a handled meter, measures peak expiratory flow rate (PEFR), the maximum speed at which they can exhale (2). Peak Expiratory Flow Rate [PEFR] Peak expiratory flow rate is the maximal rate of air flow which is a subject can achieve by a forced expiration. The peak flow, which is sustained for only a fraction of a second, occurs in the earliest part of expiration(4). The simplicity of the method is its main advantage. Normal person it is 400 Liter per minute(5). PEFR is measured by the subject inhaling to total lung capacity and exhaling into a peak flow meter with maximal effort PEFR measured using peak flow meter(6). PEFR depends on some factors the sex, age, weight, height, body-size, and muscular forces of the individual subject(4). The normal value for a given person can be determined referring to a Nomo gram. In general, the taller or younger the individual, the higher is his PEFR Normal males have a higher PEFR than normal females of the same age and height. In normal males the range of PEFR lies between 450 and 700 liters per minute (L/min.). Normal females have a lower range between 300 and 500 L/min(4). It is lower in children than in adults. It is highest in early adult life, and decreases in old age. It is higher in tall people than in short people(7). PEFR may be unrecordable on the standard Wright peak flow meter which cannot measure PEFR if it is less than 60 L/min(4). Recently a low-range, peak flow meter has been introduced which will measure much lower values of PEFR This would be appropriate for use in children(4). Peak flow meter There are two different types of peak flow meters which are Wrights peak flow meter and mini peak flow meter(4): which is an inexpensive, light and portable instrument(1,4): that can be handled easily and use to get bedside measurement. This device used to monitor a persons ability to breathe out air. This device is simpler and cheaper than spirometer. The first peak flow meter was designed by Wright and was fully described by Wright and McKerrow (1959). Recently another type of peak flow meter was presented. This device, named the Hildebrandt pneumometer, operates on an completely different principle from the Wright meter(4). A report on the Hildebrandt pneumometer and its use in general practice is published elsewhere. In the present study all PEFR measurements were made with a Wright meter. This operates on mechanical principles(4). The subject expires forcibly into the meter which causes a vane inside it to move against a spring resistance. The vane comes to rest at a position which depends upon the PEFR(4). attained. A pointer attached to the vane indicates PEFR on a dial which is calibrated in liters per minute. No calculations have to be made(4). Method of taking PEFR measurements This is an extremely simple and cheap test(3). Peak flow meter should be held horizontally and the dial must be in a vertical plane(4). Standing is the best position for taking measurements(7). It is measured using a standard Wright Peak Flow Meter or mini Wright Meter. The needle must always be reset to zero before PEF is measured. Care must be taken that the lips must be placed tightly around the mouthpiece and it is also important that he holds the meter correctly(4). The highest of three readings is used as the recorded value of the Peak expiratory flow rate(3). It may be tracks on graph paper chart with a record of symptoms or using peak flow mapping software. This allows patients to self-monitor and This allows patients to self-monitor and pass information back to their doctor or nurse. It is highly important that the subject not only understands what he is required to do but makes a maximal effort(4). If a subject has not previously performed the test careful explanation and i nstruction must be given followed by a demonstration blow by the doctor(4). Once the subject has gained confidence after one or two trial blows, Subjects are asked to take a full inspiration to total lung capacity and then blow out forcefully into the peak flow meter(4). Failure to observe that all these conditions are satisfied will result in serious errors. Different brands and models of peak flow meters often yield different values when used by the same person. Hence patients should always use the same model in the home or the doctors clinic(7). At hospital, PEFR is measured using a low-reading peak flow meter, as an ordinary meter measures only from 60 L/min upwards(3). Lung Diseases PEFR Respiratory disease Lung diseases are something. Disease or disorder that occurs in the lungs or what is causing the light that does not work correctly (8). Lung diseases are the three main types, namely: Obstructive airway disease: these diseases affect the Airways that carry oxygen and other gases to and from the lungs. These diseases cause the usually declining or blocking the airway. Including asthma, emphysema and chronic bronchitis (8). People who have respiratory diseases sometimes describe the feeling that you try to blow air through a chaff. Restrictive lung diseases: they are also called the lung tissue diseases. These diseases affect the configuration of lung tissue (8). Scarring or tissue inflammation makes the lungs cannot expand fully. This makes it difficult for the lungs breathe in oxygen and carbon dioxide out. Pulmonary fibrosis and sarcoidosis are examples of the lung tissue. People sometimes describe the feeling is very tight sweater or bestow it will not be able to take a deep breath (8). Lung circulation diseases: these diseases affect blood vessels in the lungs. Tread depth caused by coagulation or inflammation of the blood vessels (8). They affect the lungs of oxygen and carbon dioxide out. These diseases may also affect heart function. Many lung diseases involve a combatiinon of these three types. Asthma, Atelectasis, Bronchitis, COPD(chronic obstructive pulmonary disease), Emphysema, Lung cancer, Pneumonia, Pulmonary edema (2,4,8). Importance of PEFR in Lung diseases Determination of Peak expiratory flow rate is useful for assessing the respiratory diseases especially to differentiate the obstructive and restrictive respiratory diseases (5). Peak expiratory flow rate (PEFR) measurements on waking, prior to taking a bronchodilator and before bed after a bronchodilator, are particularly useful in demonstrating the variable airflow limitation that characterizes the disease (3). The diurnal variation in PEFR is a good measure of asthma activity and is of help in the longer-term assessment of the patients disease and its response to treatment. To assess possible occupational asthma, peak flows need to be measured for at least 2 weeks at work and 2 weeks off work (3). Generally PEFR in reduced in all type of respiratory diseases. However the reduction is more significant in the obstructive diseases such as asthma, emphysema, COPD (chronic obstructive pulmonary diseases) and chronic bronchitis than in the restrictive diseases (5). Sometimes in severe re strictive lung disease, PEFR values reduced much more. So in that conditions peak flow meter cannot be used to differentiate between restrictive lung diseases from obstructive airway diseases. So PEFR measurement is useful in management obstructive airway diseases. PEFR value is more important in asthma than other respiratory diseases. Importance of PEFR in Asthma Asthma is characterized by spastic contraction of the smooth muscle in the bronchioles, which partially obstructs the bronchioles and causes extremely difficult breathing (9). It occurs in 3 to 5 per cent of all people at some time in life. The usual cause of asthma is contractile hypersensitivity of the bronchioles in response to foreign substances in the air. In about 70 per cent of patients younger than age 30 years, the asthma is caused by allergic hypersensitivity, especially sensitivity to plant pollens (9). In older people, the cause is almost always hypersensitivity to nonallergenic types of irritants in the air, such as irritants in smog (9). Classically asthma has three characteristics: Airflow limitation which is usually reversible spontaneously or with treatment (3) Airway hyperresponsiveness to a wide range of stimuli (3) Inflammation of the bronchi with T lymphocytes, mast cells, eosinophils with associated plasma exudation, oedema, smooth muscle hypertrophy, matrix deposition, mucus plugging and epithelial damage (3). In chronic asthma, inflammation may be accompanied by irreversible airflow limitation as a result of airway wall remodeling that may involve large and small airways and mucus impaction (3). Asthma is usually diagnosed by the demonstration of airflow limitation. PEFR variability as one of the important diagnostic features of asthma (10). Serial measurements of PEFR in most patients with asthma show spontaneous variability. The most characteristic pattern is of a circadian variation, with airflow limitation most severe on waking in the morning (and during the night if awoken) with improvement occurring during the morning after waking. A small circadian variation in PEFR or FEV 1 is seen in normal individuals; in asthma a difference of 20 per cent or more between the highest and lowest values may be found (11). Other patterns of variation in severity of airflow limitation may be imposed on this circadian rhythm, such as falls in PEFR provoked by exercise or exposure to an allergen or occupational sensitizer, which resolve after avoidance of the stimulus. While variations of 20 per cent or more in FEV 1 or PEFR are commonly regarded as indicating asthma, in patients with se vere airflow limitation, with an FEV 1 of 1 liter, 20 per cent variability equates to 200 ml, a level of spontaneous variation observed in people without asthma (11). In asthma, the resistance to airflow becomes especially great during expiration, sometimes causing tremendous difficulty in breathing (2). Peak flow readings are divided in three zones of measurement, are green, yellow and red. Doctors and health experts can develop asthma controlling plan based on the green-yellow-red areas(12). Green Zone - 80 to 100 percent of the regular reading or normal peak flow is clearly a treatment in green zone peak flow indicates that is under good control(12). Yellow Zone 50 to 79 percent of the usual or normal peak flow readings Indicates caution. This can lead to respiratory system is restrictive. additional drugs may be required(12). Red Zone - 50% of the normal or usual peak flow readings indicate a medical emergency. serious airway narrowing may occurring and immediate action needs to be taken. This would usually involve contacting a doctor or hospital (12). The management of asthma relies on a patients ability to monitor their asthma regularly. PEFR Monitors changing in airflow limitation in asthma. People with asthma can use it to monitor themselves and alter their medication, as suggested by their doctor, at the first signs of any fall in peak flow measurement which indicates a descent in their condition. If the patient knows his best measurement of PEFR, drop in its value of up to 10 percent, indicates caution but no danger, as this much variation is not unexpected over a period of 24hours (7). A drop of 10 to 50 percent indicates that the patient is in danger of getting an attack. If the drop is more than 50 percent, the patients in an imminent danger of getting the attack. He must approach his physician who may examine him in the emergency department of the hospital (7). The correct knowledge of the PEFR predicts the condition of the patient and provides valuable time and opportunity to take all the necessary measures to prevent an attack of asthma (7). Self-monitoring includes assessing the frequency and severity of symptoms (such as wheezing and shortness of breath) and measurement of lung function with a peak flow meter. (4) When measuring PEFR in patients with asthma or bronchitis, it is important to instruct them first to clear their bronchial airways by coughing. The effect of so doing may be considerable (4). Patients should be instructed to record peak flow readings after rising in the morning and before retiring in the evening. A diurnal variation in PEF (the lowest values typically being recorded in the morning) of more than 20% is considered diagnostic and the magnitude of variability provides some indication of disease severity (13). People with asthma can use it to monitor themselves and alter their medication, as suggested by their doctor, at the first signs of any fall in peak flow measurement which indicates decline in their condition. There are some significance PEFR in asthma patient the decreased rates of expirati on of air as expressed in decreased PEFR in asthma patients, occur earlier than the production of the symptom of breathlessness or even the signs of wheeze and ronchi detected through the stethoscope. By the time, wheezing is detected through the stethoscope; the PEFR has already decreased by 20 percent or more (7). Poor perception of the severity of asthma, on the part of the patient and physician, has been cited as a major factor causing delay in treatment, and this may contribute to increased severity and mortality from asthma exacerbation (7). Patients also measured PEFR twice a day (morning and evening) by using a peak flow meter before self-administering asthma drugs and noted the PEFR value in their asthma diary. Acute severe asthma the term status asthmaticus was defined as asthma that had failed to resolve with therapy in 24 hours. In this condition, PEFR is Circadian rhythm in peak expiratory flow rate in a patient with asthma recovering from an acute attack (11) Brittle asthma(11) is characterized by widely varying peak flow rates uncontrolled by maximum inhaled treatment. Two patterns of brittle asthma have been distinguished: type I-persistent daily chaotic variability in peak flow (usually greater than 40 per cent diurnal variation in PEFR more than 50 per cent of the time); (11) type II-sporadic sudden falls in PEFR against a background of usually well-controlled asthma with normal or near normal lung function.(11) A drop of PEFR also indicates that the patient has been exposed to allergenic environments. He must try to localize the cause and prevent recurrence of the situation. PEFR reading also helps in monitoring the improvement in the patient after a particular mode of treatment (7). The following patients should keep a peak flow monitor at home and use it: (7) Patients who experience severe attacks with little warning. Patients who need to travel long distance to receive medical attention. Patients who require high-dose inhaled corticosteroids or daily oral corticosteroids. Patients with big ups and downs in peak flow, that is, greater than 20 percent of their best peak flow. Patients whose medical history appears to provide an unsatisfactory guide to treatment. There are two very important reasons for taking flow reading at home. First, asthma doesnt behave the same way 24 hours a day. It tends to get spontaneously worse at night and get better during the day (7). Without peak flow meter at home, the physician can only guess how the patient was doing at home. Second, having a meter at home allows the patient to telephone the doctor during the night and get proper instructions for management of his case. Nine times out of ten, a Physician experienced with home peak flow, can help get his patient out of trouble quickly and avoid uncalled for visit to an emergency room or hospital (7). PEFR use in Chronic obstructive Pulmonary Diseases (COPD) Chronic obstructive pulmonary disease (COPD) refers to any disorder in which there is a long-term obstruction of airflow and a substantial reduction in pulmonary ventilation (2). The major COPDs are chronic bronchitis and emphysema. This is obstructive airway diseases like Asthma. They are almost always caused by cigarette smoking, but occasionally result from air pollution or occupational exposure to airborne irritants (2). Like in asthma, variability of PEFR value is important in diagnosing and after prognosing of COPD. Patients with chronic bronchitis are unlikely to achieve a P.E.F. higher than 400 L/min: if their condition is complicated by emphysema, values of less than 200 L/min are usually found (4). In severe emphysema or in status asthmaticus PEFR may be unrecordable on the standard Wright peak flow meter which cannot measure PEFR if it is less than 60 L/min (4). The importance of identifying chronic bronchitis at a stage before serious, irreversible changes have occurred should need no stressing. Unfortunately, the early symptoms of chronic bronchitis are so unobtrusive that patients seldom attach any importance to them: (4) therefore early chronic bronchitis is likely to be recognized only if it is specially looked for. Nobody is better placed to do this than the general practitioner now that his task has been made less formidable by the provision of objective means of assessment. Though the limitations of PEFR as an index of early chronic bronchitis have yet to be fully measured, there is no doubt that a peak flow meter will enable general practitioners to identify many early bronchitis with much greater confidence than is possible on clinical findings alone (4). Other uses Also absolute peak expiratory flow rate (PEFR) has been a valuable measurement in the differentiation of acute dyspea secondary to congestive heart failure (CHF) or chronic lung disease (CLD) (15) In experimental research, it was discovered the mean absolute PEFR was 229.9 L / min for the congestive heart failure group and 121.12 L / min for the CLD group; the difference was significant. No single cut off value allowed 100 % accurate classification. However, a PEFR greater than 150 L / min was suggestive of CHF. Whereas a reading less than or equal to 150 L / min was suggestive of CLD. The Peak Expiratory Flow Rate (PEFR) is Valuable in differentiation between CHF and CLD (15). Advantages and Disadvantages of PEFR There are some advantages and disadvantages utilizing peak flow meter in management of respiratory diseases. A peak flow meter that is an inexpensive, portable, handheld device and need no source of electricity and require the minimum of maintenance (4), can be used at the bedside, can be bought any person from market. Peak flow meters are very helpful if person have moderate to severe asthma and require daily asthma medications. Even children ages 4 to 5 and up should be able to use a peak flow meter with good results. People with moderate-to-severe asthma should have a peak flow meter at home (14). Although reproducible, PEFR is not a good measure of airflow limitation since it measures the expiratory flow rate only in the first 2 ms of expiration and overestimates lung function in patients with moderate airflow limitation (3). PEFR is best used to monitor progression of disease and its treatment. Regular measurements of peak flow rates on waking, during the afternoon, and before bed demonstrate the wide diurnal variations in airflow limitation that characterize asthma and allow an objective assessment of treatment to be made It can be difficult to distinguish between asthma and COPD(3): that are same feature respiratory diseases. Also a significant peak flow variability is present in, bronchiectasis, and PTLD, although PEFR remains the most important feature favoring the diagnosis of asthma (10). So there are some difficulties in differentiation of asthma from other obstructive respiratory diseases each other. This is Effort-dependent Poor measure of chronic airflow limitation (3). Older people with poor vision have difficulty reading PEF meter recordings (6). It is important to know that peak flow meter only measures the amount of airflow out of the large airways of the lungs (14). Changes in airflow caused by the small airways (which also occur with asthma) will not be detected by a peak flow meter. Early warning signs, however, may be present. Therefore, it is important, symptoms and early warning signs to best manage in asthma. The most clinically useful measurements of airflow limitation except PEFR are forced expiratory volume in 1 s (FEV 1), which may be expressed as a proportion of the forced vital capacity (FVC) as FEV1/FVC per cent (11). Both tests require the patient to provide a reproducible maximal forced expiratory maneuvers using tested and validated equipment. FEV1 has the advantage of a visible tracing of the expelled volume of air over time, which allows the observer to determine whether reproducible maximal forced expiratory manoeuvres have been made (11). PEFR testing does not provide this opportunity. However, peak flow meters employed to measure PEFR, unlike spirometers required to measure FEV1, can be used regularly by patients to monitor their lung function (11).

What is Worldview? Essay examples -- Christian Worldview, Biblical Wor

After reading the fourth chapter heading of Consider, the first definition of worldview that came to my mind was â€Å"view of the world† just from a literary perspective. The co-authors defined worldview as â€Å"a framework a person brings to decision-making† (Weider & Gutierrez, 2011, p.51). Everyone has a worldview with main characteristics that are ever changing. Different sources influence this framework such as parenting, friendship, telecommunication or internet media, educational and religious sectors. Hindson and Caner (2008) propose standardization methods of worldview are measured either by emotions and feelings, socialism, or the truth (Hindson & Caner, 2008, p.499). Recognition of a person’s worldview can be found based on ones answer to several reality questions surrounding God (origin), human nature (identity), reality (meaning/purpose), after life (destiny), values (morality or ethics). My own definition of worldview is set of beliefs about the most important issues in life and my reaction to it. While in agreement with Jeff Baldwin’s eyeglass concept, I choose to compare my Christian worldview to an internal navigational system. When I am lost and need to be found, Christ is omnipresent. He knows my location and guides me into another direction. â€Å"It’s a roadmap, a guide for getting around in life, for interpreting reality, and for making choices† (The Importance of Worldview, 2011, p.11). Hopefully my final destination will be in the â€Å"city of gold, as clear as glass† (NLT, Revelation, 21:18). â€Æ' BIBLICAL/CHRISTIAN WORLDVIEW The Question of Origin As the first book of the Old Testament convey, Genesis, and its Greek meaning â€Å"in the beginning,† life originated with God in the Garden of Eden. Accor... ...concerns that I have for others. Work Hard From Genesis throughout the New Testament, God put us humans to work. The Bible condemns laziness (Proverbs 19:15) and every man or woman should be providers of their household through hard work (Proverbs 14:23). Personally, I cannot find anything in the Scripture that will guide me towards a certain career path. However, in all jobs Christians must work wholeheartedly by exceling in performance not for the employer but for Christ (Colossians 3:23) â€Æ' References A Sure Foundation. SMI Healthcare Bible Study (The Importance of Worldview, 2011, p.11) Retrieved from http://www.thesmi.org/HCBS/hcbs2.PDF Hindson, E., & Caner, E. (2008). The Populer Encyclopedia of Apologetics. Eugene: Harvest House Publishers. Weider, L., & Gutierrez, B. (2011). Consider. Virginia Beach: Academx Publishing Services, Inc

Madness in College Athletics Isnt Confined to March :: Sports Basketball Essays

The basketball arena is packed with a sellout crowd of over 13,000 cheering fans. The television cameras capture the game for the entire nation. A horn blares, and the game, which was supposed to be a blowout, is now in overtime. The pressure is huge, because if the underdog wins, it would make history. Both teams are anxious, but focused, knowing that one misstep, misjudgment, or misfire could make or break the season, and everything they have worked for all year. Such was the scene during the recent ‘March Madness† game, between #4 seeded Syracuse, and #13 seeded Vermont, a.k.a. the ‘Cinderella Story,’ of this year’s NCAA tourney. The Catamounts, who were not expected to make much noise during the tournament, opened it with a bang, after securing a win over powerhouse Syracuse in the final seconds of overtime. Now imagine, a player on Vermont’s super squad. He has spent the past few years working nonstop to get to this point in his basketball career, and it has finally arrived. However, after the cheering, congratulations, and celebrations, he must go back to school, and finish studying for midterms, which happens to coincide with the post-season schedule. When fans watch March Madness, or any other college sporting event, it is safe to say that most don’t look at their TVs, and think about how the athletes will spend the bus ride home trying to catch up on the schoolwork they missed so they could compete in the away game. However, this is the reality of a college student-athlete. There are constant obligations to fulfill, and expectations to be met, on every level, and most of the time, the reality is stressful. â€Å"Athletes have additional time constraints, and pressure to perform not only academically, but athletically†¦.and then there’s the stress that their body undergoes,† said Lauren Haas, director of student-athlete support services at Northeastern University. Haas also pointed out that student-athletes face a strain to try and lead the life of a normal college student, even though they have additional requirements. Student-athletes often have similar obligations to the average student, in the classroom, and in the workforce. Academically, athletes must complete the same amount of schoolwork as their peers, although they have less time to complete it, and they miss classes to participate in scheduled competitions. Most professors do not offer an extension on the workload. Financially, many athletes have jobs to offset tuition costs, which they must juggle into a busy schedule.

Macbeth- General Information, Rough Essay

then is revealed as being weak and easily manipulated. He then descends into become a murderous madman. one realizes Macbeth’s transformation into one of drama’s most infamous villains coincides with a profound transformation of his conscience—to a point where he has none at all. Throughout the play Macbeth makes a journey from following a moral ethic, implementing a flawed ethic, and arriving to a point where he had none at all. When comparing Banquo and Macbeth, after they meet the weird sisters, one see’s that Banquo adheres to warrior ethics where Macbeth moves away from it.At the start of the play Macbeth was idolised by everyone and thought to have been a man of very great power whom could be defeated by nobody: â€Å"All is too weak for brave Macbeth – well he deserves that name† 1. 2. 15. It is stated in this quote by the Captain that at the start Macbeth was known as a brave heroic man, which his enemies were too weak to overthrow. B y the end of the play his status falls from a man of great magnificence to one that has barely managed to keep his own sanity.Thus our first description of Macbeth is that of a brave, loyal soldier defending his King and country He appears to be a strong military leader ‘brave Macbeth- well he deserves that name’’, is then called ‘noble Macbeth' and given the traitor’s title, Thane of Cawdor: ‘’with this former title greet Macbeth’’. The Captain tells the King killed the traitor Macdonald in a very horrible and gory manner ‘’unseamed him from the nave to th’chops’’ Therefore, we are led to believe that Macbeth is a good, loyal, courageous, and determined man.Things From the moment they are introduced to the play the witches are seen as a negative effect on Macbeth, creating chaos by prophesysing to Macbeth that he is going to become Thane of Cawdor ‘’All hail, Macbeth! Hail to thee, Thane of Cawdor! ’’ and that he is going to become king ‘’All hail, Macbeth! That shall be King hereafter’’and getting him to act. He knows he is already Thane of Glamis, but does not know that Duncan has promoted him to Thane of Cawdor. Macbeth is surprised by the promise of kingship.Banquo's prophecy is even more fantastic: he will be the father of kings but not king, and will be greater and happier than Macbeth. That is the moment when Macbeth wants to know more. The witches basically planted the seed of evil in Macbeth’s mind that later on grew to dominate his every action. However, it was Macbeth’s ambition that decided to take action on these prophesies, therefore it was he that decided the final outcome. When Ross and Angus enter to proclaim Macbeth's promotion, he is very surprised:‘’The Thane of Cawdor lives, why do you dress me in borrowed robes? ’ Moreover, Macbeth believes that this is the f ulfilment of the witches prophecies, However, there is no clear reason why Macbeth would become king, especially since the present King is so loved and admired. In the next few lines it becomes apparent that Macbeth not only has thought about being king, but he also believes what the witches told him is true: Glamis, and Thane of Cawdor: The greatest is behind Two truths are told, As happy prologues to the swelling act Of the imperial theme. (1. 3. 115-116, 126-128)This is the first time we see him realising that he might have to do something, as killing Duncan, in order to get to the throne. He debates the good and the bad side of the prophecies : ‘’If good, why do I yield to that suggestion whose horrid image doth unfix my hair’’ we are shown that Macbeth not only loves his King and country,’’our duties are to your throne and state, children and servants’’ but also himself. It still remains to be seen what action he will take. Macbeth's change has begun. **Soon enough, we are taken to Macbeth’s home, wherewe meet his wife, Lady Macbeth. Lady Macbeth has just received a letter from her husband in whichhe tells her everything that has happened. Because the witches got him very interested in their prophecies, he has had them investigated and has ’’ learned by the perfectest report that they have more in them than mortal knowledge. ’’ It is clear that after calling the witches ‘imperfect speakers' (1. 3. 68), Macbeth has now changed his mind. He also interprets the prophecies and tells his wife a slightly changed version.He addresses her ‘’my dearest partner in greatness’’ and seems to be sincere. Lady Macbeth, however, is determined that her husband becomes king. she says that Macbeth lacks the qualities necessary to assassinate Duncan without remorse or regret: ‘’yet do I fear thy nature, it is too full o’th’milk of human-kindness to catch the nearest way’’ . she hen prays for supernatural help to take away all of her feminine qualities and basically any traits of conscience: ‘’ unsex me here, and fill me from the crown to the toe top full of direst cruelty! ’, ‘’stop up th’access and passage to remorse’’, ‘’that my keen knife see not the wound it makes’’. After Macbeth arrives, Lady Macbeth is telling him to ‘’look like the innocent flower, but be the serpent under’t’’ and to ‘Leave all the rest to me' This implicates her in the murdering of Duncan and shows us that she is taking the responsibility. She is essentially taking over. After the King arrives at the castle and prepares to sleep peacefully, Macbeth is still debating how he can achieve the crown without getting caught.He doesn’t want to do it personally; he wants to get it over with:’ ’ If it were done, when’tis done, then ‘twere done well it were done quickly’ and doesn’t really want to kill his cousin and King; he has a conscience: ‘’he’s here in double trust’. On the other side, he’s obsessed with becoming king and his thoughts keep flowing in the same direction: ‘’I have no spur to prick the sides of my intent, but only vaulting ambitions, which o’er-leaps itself and falls on the other’’. We see duality when he says: ‘’we will proceed no longer in this business’’ and tries to procrastinate the murder.His wife then plays games with his mind and basically psychologically bullies and pressures him into killing Duncan by telling him that he is less than a man if he does not carry out the murder:’’ when you durst do it, then you were a man; and, to be more than what you were, you would be so much more the man’â€℠¢, and that she, being a woman has more strength of purpose than he does: ‘’i would, while it was smiling in my face, have plucked my nipple from his boneless gums, and dashed the brains out, had i sworn as you have done to this’. As soon as Macbeth has kills Duncan, he seems to start to lose his ind. He starts hallucinating: ‘’is this a dagger which i see before me, the handle toward my hand?Come, let me clutch thee. I have not, and yet I see thee still’’. He is unable to think clearly and is very paranoid. He is ready to eliminate anything that stands in his waybecause oft his ambitions for himself and the fear of being discovered. He just doesn't know what to do with himself while trying to keep the crown. Even though he is committed to Duncan, he Because Macbeth is afraid of the witches’ prophecy that he will lose the crown: ‘’To be thus in nothing, but to be safely thus.Our fears in Banquo stick deep’â₠¬â„¢ and Banquo will become king, he sends people to kill Banquo and Fleance. He hires three murderers in order to make sure that they won’t be able to escape. They ambush Banquo on his way to a royal feast, but Fleance escapes into the night. Macbeth is now the prisoner insolent and nagging doubts and fears,: ‘’But now I am cabined, confined, bound in to saucy doubts and fears’’, and is now paranoid because Fleace has escaped: ‘’There the grown serpent lies; the worm that’s fled hath nature that in time will venom breed’’.

Elder Abuse Essay

Elder abuse is a horrible problem: during people’s sunset years, they should relax and be comfortable, not have to worry about abuse from family members and caregivers. However, the issue of people abusing the vulnerable elderly is a growing one in the United States. What causes it? This essay explains a growing theory that accounts for the causes of elder abuse. According to Quinn and Tomita (1997), there are five main hypotheses for elder abuse (Quinn & Tomita, 1997, pp. 86-87). The first is simple power: some people simply focus on dependency issues (Quinn & Tomita, 1997, pp. 86-87). Others are acting out due to the stress of acting as a caregiver; this is particularly common within family caregiving settings (Quinn & Tomita, 1997, pp. 86-87). Another hypothesis states that elder abuse is simply caused because some individuals have grown up in families that solve problems with violence (Quinn & Tomita, 1997, pp. 86-87). Another hypothesis claims that some are related to ind ividual abuser’s problems, such as substance abuse and depression (Quinn & Tomita, 1997, pp. 86-87). Finally, the last hypothesis states that in some societies, elders have lost their personhood due to greed, lookism, and hatred of the disabled. Most other studies support at least one of these hypotheses. For example, Brandl and Raymond found that the most common cause of elder abuse was caregiver stress, regardless of whether the caregiver was a family member or professional; they also emphasize the role of the elderly person: an abused child may abuse their parent once the parent is frail, for example; this connects to Quinn and Tomita’s hypotheses of violent families and individual abuser’s problems (Brandl & Raymond, 2012). Nerenberg, too, claims that caregiver stress is the main cause of elder abuse (Nerenberg, 2002). She emphasizes the perspective of the caregiver, particularly the first-time caregiver, as these individuals are more likely to engage in elder abuse (Nerenberg, 2002). Meanwhile, Hawes focuses on professional caregivers’ abuse of the elderly in long-term care facilities (Hawes, 2003). Hawes does not offer many causes, but hints at them by discussing the low pay and high-stress nature of caregiving jobs (Hawes, 2003). Thomason ascribes the causes of elder abuse to a changing society in which people live longer and are ill-prepared for caretaking (Thomason, 2011). He emphasizes the social  causes of elder abuse, focusing on the need to make everyone aware of the issues related to elder abuse and aging (Thomason, 2011). In contrast, and by focusing on the individual level, Vetere emphasizes caregiver burnout as a major cause of elder abuse (Vetere, 2011). Bronwell addresses the causes of elder abuse only implicitly, but presents data on the low pay and long hours in the caregi ving industry and also discusses the aspects of burnout and frustration that can cause family-based elder abuse to occur (Brownwell & Podnicks, 2005). In addition to discussing the elderly abusing themselves by failing to engage in self-care, they also offer data that some risk factors mean one is more likely to become an abuser: a low level of education, mental retardation (by the caregiver), substance abuse by either the elder or the caregiver, a prior history of violence or psychiatric issues, and stress (Gorbien & Eisenstein, 2005, p. 282). Gorbien and Eisenstein (2005) proposed five archetypes for abusers of the elderly, which are the overwhelmed, the impaired (e.g., mentally or physically), the narcissistic, the bullying, and the sadistic (Gorbien & Eisenstein, 2005, p. 284). In keeping with the overall causes mentioned by Quinn and Tomita, these archetypes offer reasons individuals may turn to abuse (Quinn & Tomita, 1997). Thus it can be said that a theory for the causation o f elder abuse is that within a context of a society that is poorly equipped to deal with the elderly, and within an individualist, looks-oriented society that discriminates against the disabled, many people are ashamed or frustrated by their relatives’ (or clients’, in the case of professional caregivers) decline. This feeling of helplessness and disgust, combined with stress and burnout – exacerbated due to the poor preparation most family caregivers have, and the long hours and poor pay offered to many professional caregivers – creates a context in which abuse is likely. Additional factors, like abuse from the elders themselves (e.g., bitter about losing capacity, holding long grudges against family members, aggression due to cognitive decline such as through Alzheimer’s) can spark an abusive incident. Moreover, if an individual has any of the characteristics noted by Gorbien and Eisenstein, they may be more likely to abuse. Working towards a theory of elder abuse, one can imagine a flow chart (provided on the next page). First, the background of this abuse occurs against a context of a society fiercely focused on beauty and ableism. Second, if an individual ends up  caring for an elder and they are poorly prepared or compensated, this context intensifies. Third, if an individual is impaired in some way, he or she will quickly become burned out and stressed. Fourth, pre-existing interpersonal factors like abuse are exemplified in elder caregiver situations. Fifth, some personality types (narcissists who want others to admire them for their s upposed selflessness; sociopaths) want to care for elders for their own sick needs. Sixth, if a caregiver has a risk factor such as low IQ, low education, substance abuse, or mental health issues, he or she is more likely to be an abuser. Finally, caregivers suffer burnout, and eventually, when caring for an elder individual, they may engage in a violent incident. This theory is outlined in the flowchart below, which moves from left to right. Major causes are represented by larger circles. Works Cited Brandl, B., & Raymond, J. A. (2012). Elder Abuse and the Elder Justice Movement in America. San Francisco, CA: American Society on Aging. Brownwell, P., & Podnicks, E. (2005). Long-Overdue for the Critical Issue of Elder Abuse and Neglect: A Global Policy and Practice Perspective. Oxford: Oxford University Press. Gorbien, M. J., & Eisenstein, A. R. (2005). Elder Abuse and Neglect: An Overview. Philadelphia, PA: Elsevier. Hawes, C. (2003). Elder Abuse in Residential Long-Term Care Settings: What Is Known and What Information Is Needed? Washington, DC: National Academies Press,. Nerenberg, L. (2002). Preventing Elder Abuse by Family Caregivers. Washington, D.C.: National Council on Elder Abuse. Quinn, M. J., & Tomita, S. K. (1997). Elder Abuse and Neglect: Causes, Diagnosis, and Intervention Strategies. New York: Springer Publishing Company. Thomason, D. (2011). Addressing The Cause of Elder Abuse: A Critical Component to Aging Health Policy. Retrieved October 16, 2013, from Kaplan Unv iersity Online: http://www.kaplanuniversity.edu/public-service/articles/addressing-elder-abuse.aspx# Vetere, P. M. (2011). Elder Abuse: What Are We Missing? Ottawa: The College of Family Physicians of Canada. Woolf, L. M. (1998). Elder Abuse and Neglect. St. Louis, MO: Webster University.