Obs of a Prnnl Lrnr Obsrvr who happens to be a dctr There is no cure for curiosity-D Parker
Wednesday, 30 September 2015
Tuesday, 29 September 2015
It is not what happens to us that determines our character, our experience, our karma, and our destiny, but how we relate to what happens.
It is not what happens to us that determines our character, our experience, our karma, and our destiny, but how we relate to what happens.
Sunday, 27 September 2015
Morality is a device for solving the social challenges of everyday life, where the basic problem is to get otherwise selfish individuals to work together as a group and enjoy the benefits of cooperation,” says Joshua Greene
Morality is a device for solving the social challenges of everyday life, where the basic problem is to get otherwise selfish individuals to work together as a group and enjoy the benefits of cooperation,” says Joshua Greene
CURIOUS CASE OF B BUTTON
In my next life I want to live my life backwards. You start out dead and get that out of the way. Then you wake up in an old people's home feeling better every day. You get kicked out for being too healthy, go collect your pension, and then when you start work, you get a gold watch and a party on your first day. You work for 40 years until you're young enough to enjoy your retirement. You party, drink alcohol, and are generally promiscuous, then you are ready for high school. You then go to primary school, you become a kid, you play. You have no responsibilities, you become a baby until you are born. And then you spend your last 9 months floating in luxurious spa-like conditions with central heating and room service on tap, larger quarters every day and then Voila! You finish off as an orgasm!
- Woody Allen
NEWS EMPATHETIC STRESS-“The constant stream of devastating news with which we are confronted with in the daily media has the potential to compromise a significant range of people.
“The constant stream of devastating news with which we are confronted with in the daily media has the potential to compromise a significant range of people.
Saturday, 26 September 2015
Sandoval: A guy can change anything. His face, his home, his family, his girlfriend, his religion,his God. But there's one thing he can't change. He can't change his passion...
Sandoval: A guy can change anything. His face, his home, his family, his girlfriend, his religion,his God. But there's one thing he can't change. He can't change his passion...
Oxford has found that citalopram, a selective serotonin reuptake inhibitor used to treat depression, makes people more sensitive to the possibility of inflicting harm on others
Oxford has found that citalopram, a selective serotonin reuptake inhibitor used to treat depression, makes people more sensitive to the possibility of inflicting harm on others
“We have gut reactions that guide our judgements and behaviour,” says Greene, “but we can also stop and think, and reason explicitly about situations to try to make better decisions.”
“We have gut reactions that guide our judgements and behaviour,” says Greene, “but we can also stop and think, and reason explicitly about situations to try to make better decisions.”
“Morality is a device for solving the social challenges of everyday life, where the basic problem is to get otherwise selfish individuals to work together as a group and enjoy the benefits of cooperation,” says Joshua Greene
“Morality is a device for solving the social challenges of everyday life, where the basic problem is to get otherwise selfish individuals to work together as a group and enjoy the benefits of cooperation,” says Joshua Greene
NRP-CPAP
Consider using continuous positive airway pressure (CPAP) if the baby is breathing
spontaneously and has a heart rate above 100 bpm, but is having difficulty such as labored respiration,
persistent cyanosis, or low oxygen saturation. Note: CPAP cannot be delivered with a self-inflating bag
NRP-SPL-
Lesson 7 – Special Considerations
The appropriate action for a baby who fails to respond to resuscitation will depend on
the presentation –
failure to ventilate,
persistent cyanosis or bradycardia,
or failure to initiate spontaneous breathing.
Symptoms from choanal atresia can be helped by placing an oral airway.
Airway obstruction from Robin syndrome can be helped by inserting a nasopharyngeal tube and placing the baby prone.
In an emergency, a pneumothorax can be detected by transillumination and treated by inserting a needle into the chest.
If diaphragmeatic hernia is suspected, avoid PPV by mask. Immediately intubate the trachea and insert an orogastric tube
Persistent cyanosis and bradycardia are rarely caused by congenital heart disease.
More commonly, the persistent cyanosis and bradycardia are caused by inadequate ventilation.
A baby who has required resuscitation must have close monitoring and management of oxygenation, infection, blood pressure, fluids, apnea, blood sugar, feeding, and temperature. Be careful not to overheat the baby during or following resuscitation. If a mother has recently received narcotics and her baby fails to breathe, first assist ventilation with PPV, then consider giving naloxone to the baby
failure to ventilate,
persistent cyanosis or bradycardia,
or failure to initiate spontaneous breathing.
Symptoms from choanal atresia can be helped by placing an oral airway.
Airway obstruction from Robin syndrome can be helped by inserting a nasopharyngeal tube and placing the baby prone.
In an emergency, a pneumothorax can be detected by transillumination and treated by inserting a needle into the chest.
If diaphragmeatic hernia is suspected, avoid PPV by mask. Immediately intubate the trachea and insert an orogastric tube
Persistent cyanosis and bradycardia are rarely caused by congenital heart disease.
More commonly, the persistent cyanosis and bradycardia are caused by inadequate ventilation.
A baby who has required resuscitation must have close monitoring and management of oxygenation, infection, blood pressure, fluids, apnea, blood sugar, feeding, and temperature. Be careful not to overheat the baby during or following resuscitation. If a mother has recently received narcotics and her baby fails to breathe, first assist ventilation with PPV, then consider giving naloxone to the baby
The irony of determinism is that we understand that as events occur, they are highly subjective and based on particular points of view, but once receded into the past, seemingly become set in stone.
The irony of determinism is that we understand that as events occur, they are highly subjective and based on particular points of view, but once receded into the past, seemingly become set in stone.
The mind functions by detecting patterns, structure and order, yet reality is fundamentally dynamic. So it is a dichotomy of energy and form, in which form is necessarily static, while energy is dynamic.
The mind functions by detecting patterns, structure and order, yet reality is fundamentally dynamic. So it is a dichotomy of energy and form, in which form is necessarily static, while energy is dynamic.
While we are culturally conditioned to think of good and bad as a cosmic dual between the forces of righteousness and evil, the reality is they are the basic biological binary code of attraction to the beneficial and repulsion of the detrimental.
While we are culturally conditioned to think of good and bad as a cosmic dual between the forces of righteousness and evil, the reality is they are the basic biological binary code of attraction to the beneficial and repulsion of the detrimental.
Emotions are the "feelings" that the thinking process of our subconscious thinking system, aka our emotional brain, uses to send signals to our rational brain, which, according to scientists such as the cognitive neuroscientist, Antonio Damasio, makes the final decisions as to how we respond to our environment - decisions which may or may not have needed ratification by the subconscious._.
Emotions are the "feelings" that the thinking process of our subconscious thinking system, aka our emotional brain, uses to send signals to our rational brain, which, according to scientists such as the cognitive neuroscientist, Antonio Damasio, makes the final decisions as to how we respond to our environment - decisions which may or may not have needed ratification by the subconscious._.
NRP VOLUME
Recommended volume expander
♥ Normal saline, Ringer’s lactate, or O Rh-negative blood
♥ Dose: 10 ml/kg
♥ Route: Umbilical vein
♥ Preparation: Correct volume drawn into large syringe
♥ Rate: Over 5 to 10 minutes
NRP-VOLUME
Indications for volume expansion during resuscitation include
♥ Baby is not responding to resuscitation AND
♥ Baby appears in shock (pale color, weak pulses, persistently low heart rate, no improvement in circulatory status despite resuscitation efforts) AND
♥ There is a history of condition associated with fetal blood loss (e.g., extensive vaginal bleeding, abruption placentae, placenta previa, twin-to-twin transfusion, etc.)
♥ Baby is not responding to resuscitation AND
♥ Baby appears in shock (pale color, weak pulses, persistently low heart rate, no improvement in circulatory status despite resuscitation efforts) AND
♥ There is a history of condition associated with fetal blood loss (e.g., extensive vaginal bleeding, abruption placentae, placenta previa, twin-to-twin transfusion, etc.)
NRP - AFTER 30 SEC CC AND VENT
After 30 seconds of chest compressions and ventilation, check the heart rate.
If the heart rate is ♥ Greater than 60 bpm, discontinue compressions and continue ventilation at 40 to 60 breaths per minute
♥ Greater than 100 bmp, discontinue compressions, and gradually discontinue ventilation if the newborn is breathing spontaneously
♥ Less than 60 bpm, intubate the newborn, if not already done, and give epinephrine.
If the heart rate is ♥ Greater than 60 bpm, discontinue compressions and continue ventilation at 40 to 60 breaths per minute
♥ Greater than 100 bmp, discontinue compressions, and gradually discontinue ventilation if the newborn is breathing spontaneously
♥ Less than 60 bpm, intubate the newborn, if not already done, and give epinephrine.
as populations migrate and dietary patterns become globalized, people with mtDNA optimized to one environment, where they eat a sub-Saharan African diet, may not be well adapted to another environment, where they may consume a Central European diet
as populations migrate and dietary patterns become globalized, people with mtDNA optimized to one environment, where they eat a sub-Saharan African diet, may not be well adapted to another environment, where they may consume a Central European diet
NRP-After 30 seconds of chest compressions and ventilation, check the heart rate. If the heart rate is ♥ Greater than 60 bpm, discontinue compressions and continue ventilation at 40 to 60 breaths per minute
After 30 seconds of chest compressions and ventilation, check the heart rate.
If the heart rate is ♥ Greater than 60 bpm, discontinue compressions and continue ventilation at 40 to 60 breaths per minute
If the heart rate is ♥ Greater than 60 bpm, discontinue compressions and continue ventilation at 40 to 60 breaths per minute
NRP-To ensure proper rate of chest compressions and ventilations, the compressor repeats “One -and- Twoand-Three-and Breathe-and
To ensure proper rate of chest compressions and ventilations, the compressor repeats “One -and- Twoand-Three-and
Breathe-and
NRP-CC
Locate the correct area for compressions by running your fingers along the lower edge of the rib cage
until you locate the xyphoid. Then place your thumbs or fingers on the sternum, above the xyphoid and on
a line connecting the nipples
NRP- T PIECE
T-piece resuscitators
♥ Depend on a compressed gas source
♥ Must have a tight face-mask seal to inflate the lungs
♥ Operator sets maximum circuit pressure, peak inspiratory pressure, and positive end expiratory pressure(PEEP)
♥ Peak inspiratory pressure must be adjusted during resuscitation to achieve physiologic improvement, audible breath sounds, and perceptible chest movements
♥ Positive pressure is provided by alternately occluding and releasing the hole in the PEEP cap
♥ Can be used to deliver free-flow oxygen
♥ Depend on a compressed gas source
♥ Must have a tight face-mask seal to inflate the lungs
♥ Operator sets maximum circuit pressure, peak inspiratory pressure, and positive end expiratory pressure(PEEP)
♥ Peak inspiratory pressure must be adjusted during resuscitation to achieve physiologic improvement, audible breath sounds, and perceptible chest movements
♥ Positive pressure is provided by alternately occluding and releasing the hole in the PEEP cap
♥ Can be used to deliver free-flow oxygen
NRP PPV
Indications for PPV are
♥ Apnea/gasping
♥ Heart rate less than 100 bpm after stimulation, even if infant is breathing
♥ Persistent central cyanosis despite stimulation and 100% free-flow oxygen
♥ Apnea/gasping
♥ Heart rate less than 100 bpm after stimulation, even if infant is breathing
♥ Persistent central cyanosis despite stimulation and 100% free-flow oxygen
Friday, 25 September 2015
NRP BBY VIGOROUS
To determine if baby is vigorous, the baby must meet these 3 criteria:
Strong respiratory effort
Good muscle tone
Heart rate > 100 bpm
Strong respiratory effort
Good muscle tone
Heart rate > 100 bpm
NLS POST RESUS CARE
Post-Resuscitation care encompasses 3 levels:
1. Routine Care – when the baby is vigorous and may stay with mother. Provide warmth, clear airway, dry and assess baby’s color
2. Observational Care – when the baby requires initial steps under the radiant warmer due to depressed breathing or activity, meconium-stained amniotic fluid or cyanosis. Manage with frequent evaluation and perhaps admission to a transitional nursery.
3. Post-resuscitation care – when the baby received PPV or more extensive resuscitation and is at high risk for recurrent deterioration or subsequent complications. Manage where ongoing evaluation and monitoring are available. Neonatal intensive care may be necessary
1. Routine Care – when the baby is vigorous and may stay with mother. Provide warmth, clear airway, dry and assess baby’s color
2. Observational Care – when the baby requires initial steps under the radiant warmer due to depressed breathing or activity, meconium-stained amniotic fluid or cyanosis. Manage with frequent evaluation and perhaps admission to a transitional nursery.
3. Post-resuscitation care – when the baby received PPV or more extensive resuscitation and is at high risk for recurrent deterioration or subsequent complications. Manage where ongoing evaluation and monitoring are available. Neonatal intensive care may be necessary
Provide chest compressions as you continue assisted ventilation.* ♥ If after 30 seconds of PPV the heart rate is < 60 bpm, begin chest compressions as well. ♥ If heart rate is > 60 bpm but < 100 bpm, discontinue compressions & continue PPV.
NLS
Provide chest compressions as you continue assisted ventilation.*
♥ If after 30 seconds of PPV the heart rate is < 60 bpm, begin chest compressions as well.
♥ If heart rate is > 60 bpm but < 100 bpm, discontinue compressions & continue PPV.
Provide chest compressions as you continue assisted ventilation.*
♥ If after 30 seconds of PPV the heart rate is < 60 bpm, begin chest compressions as well.
♥ If heart rate is > 60 bpm but < 100 bpm, discontinue compressions & continue PPV.
NLS=Improvement in heart rate is the primary measure of adequate ventilation If heart rate is not improving, assess chest wall movement. Higher PIP may be required
Improvement in heart rate is the primary
measure of adequate ventilation
If heart rate is not improving, assess chest wall
movement. Higher PIP may be required
PINKER- the mind as computational system; the mind is massively modular; a lot of mental structure, including a lot of cognitive structure, is innate; a lot of mental structure, including a lot of cognitive structure, is an evolutionary adaptation – in particular, the function of a creature’s nervous system is to abet the propagation of its genome (its selfish gene, as one says).
the mind as computational system; the mind is massively modular; a lot of mental structure, including a lot of cognitive structure, is innate; a lot of mental structure, including a lot of cognitive structure, is an evolutionary adaptation – in particular, the function of a creature’s nervous system is to abet the propagation of its genome (its selfish gene, as one says).
Thursday, 24 September 2015
DTHING
If you are gravely ill, then you should realize that if your life is coming to an end, then you should make peace with friends or family (for their sake moreso than yours as they'll have to live after you are gone) and try to enjoy what time that you have left.
MATHS QUOTE
“Mathematics, as it’s generally taught in American school systems, can be a saintly mother of the subject. It climbs logically and majestically from addition through subtraction multiplication, and division. Then it sweeps up towards the heavens of mathematical beauty. But math can also be a wicked stepmother. She is utterly unforgiving if you happen to miss any steps of the logical sequence—and missing a step is easy to do. All you need is a disruptive family life, a burned-out teacher, or an unlucky extended bout with illness—even a week or two at a critical time can throw you off your game. Or as with the case with me, simply no interest or seeming talent whatsoever.”
‘To watch the sun sink behind a flower-clad hill, to wander on and on in a huge forest without thought of return, to stand upon the shore and gaze after a boat that disappears behind distant islands, to contemplate the flight of wild geese seen and lost among the clouds.’ (Seami)
RAMAKRISHNA ON SEEING BALAKA -YUGEN
Wednesday, 23 September 2015
Tuesday, 22 September 2015
When we encounter this kind of feedback, the MPFC sends a signal to one of two parts of the brain: the striatum (responsible for positive rewards) or the insula (responsible for negative rewards), and we experience either positive social emotions like pride and esteem or negative social emotions like shame and embarrassment.
Monday, 21 September 2015
Sunday, 20 September 2015
Saturday, 19 September 2015
Friday, 18 September 2015
Thursday, 17 September 2015
Wednesday, 16 September 2015
big brains would have allowed us to solve problems caused by changes in rainfall, such as by making different stone tools to exploit changing food resources.NS
big brains would have allowed us to solve problems caused by changes in rainfall, such as by making different stone tools to exploit changing food resources.
A climate that shifts from wet to dry every 10 or 20,000 years would have selected for humans that had a capacity to adjust to change, whatever it may be
A climate that shifts from wet to dry every 10 or 20,000 years would have selected for humans that had a capacity to adjust to change, whatever it may be NS
Tuesday, 15 September 2015
Monday, 14 September 2015
Sunday, 13 September 2015
Saturday, 12 September 2015
Friday, 11 September 2015
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