The Soyuz 11 Space Disaster: a Case Study in Engineering Disasters

The Soyuz 11 Space Disaster: A Case Study in Engineering Disasters ENGG 123 November 20, 2011 ABSTRACT In 1971, Soyuz 11 was the first manned spaceship to contact the first space station. As the astronauts were preparing to re-enter the earth's atmosphere the crew cab depressurized and the astronauts were killed within seconds. This paper will discuss the events that happened and how they were investigated. It will also discuss how the disaster affected future engineering decisions regarding the Soyuz missions as well as other future space adventures. i Table of ContentsAbstract†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. i Table of Contents†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. ii List of Figures†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ iii 1. 0 Introduction†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 1 2. 1 What Happened†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 3. 1 What Went Wrong†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢ € ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 4 3. 2 What Was Learned†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 7 4. 0 Summary†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 8 Works Cited†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 9 List of Figures Figure 2. 1: a) a view of Soyuz 11 docked b) a view of Soyuz 11 taking off (Space Facts, n. . )†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 2 Figure 2. 2: a) seating chart for the astronauts b) the three astronauts inside Soyuz 11 c) astronauts preparing for takeoff (Space Facts, . n. d)†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 3 Figure 3. 1: a) map of the landing route for Soyuz 11 (Svens Space Page, n. d. )†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 6 Figure 3. 2: a) Soyuz 11 after landing b) workers covering up the astronauts.. 7 ii Figure 3. : a) Funeral held for the three Soyuz 11 astronauts†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 7 1. 0 Introduction The purpose of this paper is to provide background and information on the Soyuz 11 space disaster. This disaster occurred in 1971 and took the lives of three astronau ts who took part in the first successful visit to the world's first space station. This paper will provide insight on how the disaster actually happened, what the causes were of this disastrous event. It will provide insight on how the events that occurred were investigated and also what was learned from these events and what changed. 2. 1 What HappenedUnless otherwise stated the information in this section is provided from About. com(n. d. ) 1 Salyut 1, a space station made by the Soviets was the first space station to ever be made. It was launched on April 19, 1971. It was a large cylinder with three compartments, could be used with or without people inside of it and it could only dock one spacecraft at a time. The primary use of this space station was to study the effects of long term space travel on a human body, as well as studying effects on growing plants.On April 19, 1971 Soyuz 10 was the first spacecraft to attempt a mission out to the space station however this mission wa s unsuccessful. As the space craft attempted to dock it failed so the astronauts had to return to earth. On the return the ships air supply turned toxic but only one man passed out, all three astronauts recovered fully. On 2 June 6, 1971 Soyuz 11 embarked on a journey to the space station. This ship was originally supposed to be manned by Valery Kubasov, Alexei Leonov, and Pyotr Kolodin. Just before the launch, Valery Kubasov was suspected to have tuberculosis so this crew was replaced by three other men.They were: Georgi Dobrovolski, Vladislav Volkov, and Viktor Patsayev. Soyuz 11 successfully reached the space station and managed to hand dock the ship once they were within 100 metres. Once docked, problems began to take over the mission. Instruments and telescopes were not working, cramped space made it hard to work, and personalities were clashing. A small fire had even broke out at one point. This is when the crew decided to cut the mission six days short and go home. Right afte r Soyuz 11 undocked and made its way back to earth, all communication with the crew was lost.This happened much earlier than was to be expected. The ship made its way to earth and was discovered on June 29, 1971. When it was opened, all three members of the crew were found dead. The following images are from Space Facts(n. d. ) Figure 2. 1: a) a view of Soyuz 11 docked b) a view of Soyuz 11 taking off (Space Facts, n. d. ) a b Figure 2. 2: a) seating chart for the astronauts b) the three astronauts inside Soyuz 11 c) astronauts preparing for takeoff (Space Facts, n. d) abc 3 3. 1 What Went Wrong Unless otherwise stated the facts provided in this section come from Engineering Failures(n. . ) All the people on earth at the time thought this was a normal re-entry of a space craft. However upon opening the capsule the discovered differently. It was obvious to the people there that the crew had suffocated. Located between the orbital module and the descent module was a ventilation valve. As the two modules had been separated this valve was forced open. The two modules were connected via explosive bolts, these bolts were intended to fire sequentially or one after the other, but they actually fired simultaneously or at the same time.Because of this there was extra force put onto internal parts of the space craft. The ventilation valve had been jerked open by all this extra force. This valve was intended to automatically adjust cabin pressure but because it was actually opened in outer space the cabin pressure of the space craft very quickly reached zero, a fatal pressure for the cabin to be at. This valve was located underneath of the astronauts chairs making it impossible for them solve the problem. One of the astronauts was wearing a suit with biomedical sensors that showed he died within 40 seconds of the pressure loss.It only took 935 seconds for the cabin to reach a pressure of zero. 4 The facts in the next paragraph are from abyss. uoregon. edu(n. d. ) What cau sed all this to go wrong was a poor design. It should have been placed in a more accessible place. When thoughts were going into its design it was thought that it would only need to be used in an emergency, however no one thought what would be happening that it would need to be closed. The valve was intended for emergency but proved no use in the emergency because it was inaccessible.This problem could have been solved if the design team performed more tests, however it is impossible for a design team of a safety device to know every single situation that could happen. The following is a quote from Geoff Perry, Senior Science Master at Kettering Grammar School. 5 â€Å"I picked up my first signals for over 7 days on 28 June around 2110 UT   – Salyut on 20. 008 MHz and assumed that recovery would take place on 29 June around 2000 UT. Consequently I set the alarm clock for 3. a. m. BST hoping to see two objects indicating that Soyuz-11 had separated from Salyut   but that was not to be.We had no signals during 29 June and when 2000 UT came and went I went off watch, but, fortunately, left the time switch to do the pass at 2230 and 0300 UT. I did not believe that the Russians would worry about a recovery in darkness at this time of the year, considering their usual precision landings. However, they did worry and Soyuz-11 went two extra revs to give a daylight recovery. The time switch recorded signals 45 s after it had operated with LOS at 2247:15 +/- 15 s (allowing for possible variations in mains frequency affecting the clockwork).Peter Bentley had banked on a daylight recovery and was listening at Menai Bridge and gives LOS at 2247:27 +/- 1 s (or, as he says, +/- 5 s for 99% accuracy). I have therefore adopted 2247:25 +/- 5 s as LOS and the time of separation of the descent module and instrument module. The tragedy must have occurred minutes, or even only seconds, later. Telemetry at LOS was normal for a Soyuz recovery†. (Svens Space Page, n. d. ) The following is a map taken from Svens Space Page (n. d. ) showing what information the Kettering group had received from Soyuz 11. Figure 3. : a) map of the landing route for Soyuz 11 (Svens Space Page, n. d. ) a 6 The following are images from after Soyuz 11 landed. Figure 3. 2: a) Soyuz 11 after landing b) workers covering up the astronauts a b Figure 3. 3: a) Funeral held for the three Soyuz 11 astronauts a 3. 2 What Was Learned 7 After this terrible and fatal accident much thought and consideration went into the next missions. First off the USSR never again attempted to send astronauts to the Salyut 1 space station. Eventually Salyut 1 was deorbited and burnt up. It took more than two years for another man mission to be attempted About. om(n. d. ) The Soyuz spacecraft went through a lot of modifications. The first main difference was that it was redesigned to only carry two astronauts instead of three. This allowed more room inside which allowed for the astronauts to wea r space suits during the launch and the landing. The Soyuz capsule remained this way until a new design in 1980 which allowed three astronauts. 4. 0 Summary The Soyuz 11 space disaster was an extremely unfortunate event. Three astronauts died from a malfunction that should have been fixable. This is a

Prone Positioning On Critically Ill Health And Social Care Essay

In my nursing experience, I have worked in both the neonatal intensive attention unit ( NICU ) and the paediatric intensive attention unit ( PICU ) . When I worked in the NICU, our babies were positioned prone ( face down ) for comfort grounds for the bulk of a 24 hr period. Our neonatologists seldom used sedation or trouble direction resources for our automatically ventilated patients. In the PICU I presently work in, all of our automatically ventilated patients are given uninterrupted medicines for both sedation and hurting, nevertheless prone placement is about ne'er used. When I have positioned patients prone in the past, most nurses look cross-eyed at me as though I have done something incorrect. Past research has suggested that prone placement is a curative manoeuvre that improves oxygenation in both paediatric and big patient populations ( Curley et al. , 2006 ) . However, some clinical tests in both paediatric and big populations have demonstrated that there is no betterment in clinical results for the patient ( Curley et al. , 2006 ) . In other surveies, when a patient is placed in the prone place, it has been shown that there is an increased in terminal expiratory lung volume and improved ventilator-perfusion fiting taking to better oxygenation ( Gattinoni et al. , 2001 ) . As you can see, there is assorted informations from many surveies proposing prone positioning leads to break clinical results for patients. Besides, as I was researching, I truly could n't happen a survey or literature that was new within the last 5 old ages. There is a current demand for updated research surveies and information. Hopefully I can carry through and add to the research with my proposed survey.Purpose, Aims, and HypothesissThe intent of this research survey would be to bring forth informations to assist infirmaries develop a policy, process and protocol for prone placement in critically sick, paediatric patients. The informations collected from this survey can add to the literature and hopefully convey current evidence-based pattern to PICUs across the state. Harmonizing to Polit & A ; Beck ( 2008 ) , purposes can be defined as the particular accomplishments a research worker would trust to accomplish by carry oning a research survey. My proposed survey has two specific research purposes.Aim 1To prove the effectivity of prone placement in automatically ventilated, critically sick paediatric patients, related to betterments in oxygenation.Aim 2To analyze techniques in airway direction of a automatically ventilated, critically sick paediatric patient, to find the safest nursing pattern in prone placement.HypothesissFor Aim 1, the hypothesis is that paediatric patients, who are critically sick and automatically ventilated, will hold better positive clinical results related to betterment in oxygenation in prone placement than in supine placement. The void hypothesis is that there is no difference in prone or supine placement in patient clinical results. For Aim 2, the hypothesis is that there will be safe techniques in airway direction in prone placement for the automatically ventilated, critically sick paediatric patient. The void hypothesis is that there is no safe technique in airway direction in the prone place based on continued, critical inauspicious events.BackgroundThe reappraisal of literature on the effects of prone placement in automatically ventilated patients has mixed ideas. Surveies conducted by Dr. Martha Curley and her research squad from Boston Children ‘s Hospital have refuted and so accepted the usage of prone placement in automatically ventilated, critically sick paediatric patients. Curley et Al. ( 2000 ) researched the physiologic alterations of automatically ventilated paediatric patients and evaluated the safety of prone placement who experienced acute lung hurt. The information was collected from a single-center prospective instance series from October 1997 to March 1999. The sample was 25 paediatric patients with bilateral paranchymal disease necessitating mechanical airing with a partial force per unit area of arterial oxygenation ( PaO2 ) to the fraction of divine O ( FiO2 ) ratio of less than or equal to 300 millimetres of quicksilver ( mm Hg ) ( Curley et al. , 2000 ) . The patient ‘s ages ranged from 2 months to 17 old ages. The participants were placed prone for 20 hours a twenty-four hours â€Å" until clinical betterment or decease occurred † ( Curely et al. , 2000, p. 156 ) . After run intoing eligible standards, informations collected consisted of arterial blood gases, critical marks ( temperature, bosom rate and arterial blood force per unit area, and cardinal venous force per unit area. Ventilator scenes and the figure of staff utilized and the clip it took to turn a patient were besides collected. The research workers besides collected informations on the medicine profile, particularly comfort medicines such as morphia and diazepam, and assessed force per unit area ulcers and presenting. â€Å" Features of the survey population are expressed as frequences, mean ( +/- SEM ) , or average with interquartile scopes ( IRQs ; 25th and 75th percentile ) † ( Curley et al. , 2000, p. 158 ) . The survey revealed that when prone place informations measurings were compared to the patient ‘s supine measurings, there were immediate and cumulative betterments in oxygenation ( Curley et al. , 2000, p. 161 ) . The research workers conclude that their survey suggests informations that prone placement is both safe and effectual in paediatric patients with ALI. Dr. Curley and her co-workers believe that this survey provides a foundation for a hereafter randomized survey to look into early and repeated prone placement for this paediatric population. Dr. Curley and her co-workers took on a prospective, multi-center randomized survey from August 2001 to April 2004. The hypothesis of this survey was that kids with ague lung hurt treated with prone positioning would hold more ventilator-free yearss than those treated with supine placement. Patients were included if they were age 2 hebdomads to 18 old ages old, intubated and automatically ventilated with a ratio of a PaO2 to FiO2 of 300 or less, bilateral pneumonic infiltrates, and no clinical grounds of left atrial high blood pressure ( Curley et al. , 2005 ) . Exclusion standards included patients less than 2 hebdomads of age, less than 42 hebdomads post conceptual age, had relentless hypotension or intellectual high blood pressure, cardiac related respiratory failure, and a figure of other medical conditions listed by the writers in their article. Of 8017 patients screened, merely a sum of 102 participants were included in the survey. A information and safety supervising board stopped the test at the interim analysis based on the futility fillet regulation. Ninety-four patients had completes the 28-day survey period. Of these 94, 47 were in each of the groups. After statistical analysis had been done, it was determined that if the survey had reached the planned registration of 180 patients, the chance of showing a difference in ventilator-free yearss between intervention groups was less than one per centum ( Curley et al. , 2005, p. 232 ) . The survey found that there was no statistically important difference of ventilator-free yearss between supine and prone placement in paediatric patients with acute lung hurt. Dr. Curley and her co-workers do non back up the continued usage of prone placement of paediatric patients as a curative intercession to better results in acute lung hurt ( Curley et al. , 2005, p. 236 ) . This province counters the research decisions drawn from Curley et Al. ( 2000 ) . Interestingly, Dr. Curley continued her research by executing a secondary analysis on this information collected in 2006. The intent of this secondary analysis was to depict the effects of prone positioning on airway direction, mechanical airing, enteric nutrition, hurting and sedation direction and staff use in paediatric patients with acute lung hurt ( Curley et al. , 2006 ) . The research workers suggest that their informations really shows that prone placement can be accomplished safely in critically sick paediatric patients. The research workers besides province that they believe patients can be safely assess and managed piece maintained in the prone place for drawn-out periods of clip, every bit long as 20 back-to-back hours ( Curley et al. , 2006, p. 417 ) . In this article on secondary analysis performed by Dr. Curley and her co-workers ( 2006 ) , they province that prone placement should go on to be used in critically sick kids as a enlisting manoeuvre in acute lung hurt to better oxygenation, lessening force per unit area wounds, and decreased bronchopulmonary compaction. These research workers besides province that this is the first survey to clearly show that prone placement can be accomplished safely. After researching prone placement in critically sick, automatically ventilated paediatric patients, I wholeheartedly agree. I believe that this is why these surveies could be replicated to assist formalize the protocols developed by Dr. Curley and her co-workers.SignificanceThe significance of a research survey on prone placement in paediatric patients is overpowering. In my ain personal experience, there has ne'er been grounds presented to my nursing co-workers or myself on whether prone placement is really safe and effectual. As ant ecedently stated, in reexamining the literature, there are really few clinical surveies that would be considered good mentions as true province of the art, evidence-based nursing pattern. In fact, I can non believe that merely Dr. Martha Curley has taken this undertaking on for the paediatric population. This proposed survey will be able to place the effectivity of prone positioning on improved oxygenation in a automatically ventilated paediatric patient. From survey informations aggregation, techniques in safe air passage direction could assist ease the usage of prone placement in paediatric patients of all ages and sizes and possibly advance more positive clinical results. In my survey, I hope to retroflex Dr. Curley ‘s methods utilizing her protocols, with some minor tweaking. This proposed survey should add to the organic structure of literature. The significance of this survey could assist formalize Dr. Curley ‘s protocols from her past surveies and besides assist make a criterion of pattern for prone placement.Research MethodsSample, Setting and RecruitmentThe mark population to be studied would be critically sick, paediatric patients runing from ages 2 hebdomads to 18 old ages of age. Inclusion standards will besides include patients with acute respiratory hurt necessitating cannulation and mechanical airing. Exclusion standards will be patients with respiratory hurt or failure of cardiac nature. Patients will besides be excluded if they have spinal instability or hold had abdominal surgery, as it would non be safe for these patients to be prone positioned. Patients with tracheotomies will be excluded. I would trust to include patients on conventional airing and high frequence hovering airing. Patients will be excluded if they weigh over 200 lbs, as the protocol will merely utilize three staff members to turn the patient, and this may be insecure in a patient of this size. The survey participants will be recruited from paediatric intensive attention units from infirmary centres willing to take part. In day-to-day unit of ammunitions, we would allow the paediatric critical attention doctors determine if the patient ‘s medical position was stable plenty to be eligible for survey standard. Randomization of patients will be done between prone placement and supine placement by utilizing a consecutive figure system. Centers will be provided envelopes with cards denominating between prone and supine placement and assign as each new participant is eligible. A sample size that would mirror Dr. Curley ‘s would be ideal. I hope to obtain at least 100 participants, but purpose for 200 participants. With 200 participants, the hope is to duplicate the original sample size, duplicate the figure of prone-to-supine and supine-to-prone bends, and increase the cogency of the research.Data Collection and InstrumentationFor my research survey, I hope to develop a systematic extension reproduction of the old surveies done by Dr. Curley and her research squad ( Curley et al. , 2000 ; Curley et al. , 2005 ; Curley et al. , 2006 ) . Dr. Curley and her co-workers ( 2006 ) developed a prone placement protocol for bedside nurses to follow in respects to analyze participants. The protocol is attached in Appendix1, nevertheless a brief drumhead is provided to assist assistance in the shaping of informations aggregation and instrumentality. When a patient has been met standards and is designated as eligible for the survey, informations will be collected based on the Pediatric Risk for Mortality III ( PRISM III ) ( Pollack et al. , 1997 ) . Demographics such as age, race, and ethnicity will be categorized. An anteroposterior thorax radiogram, in the supine place, should be obtained to document and guarantee that the endotracheal tubing ( ETT ) is positioned decently in the deep windpipe. The security of the ETT shall be assessed every bit good, based on the establishments current protocols. The size of the ETT, whether it is cuffed or uncuffed, and arrangement shall be paperss as Ten centimetres ( centimeter ) at the gum, as in â€Å" the patient has a 4.5 cuffed ETT, taped firmly at 12 centimeter at the gum † . The turnup of an ETT should be inflated with the minimum leak technique: inflate turnup until an air leak is ascultated at end-inspiration while maintain turnup force per unit area & gt ; 25 millimeter Hg ( Curley et al. , 2006, p. 420 ) . Security of the ETT and arrangement at the gum will be documented after each bend from the supine-to-prone and prone-to-supine placement every bit good as every 4 hours while in the prone place. The nurse or respiratory healer will doc ument whether or non the patient had a nonelective extubation during the bend. In respects to soothe and clamber unity, the patient ‘s should hold separately sized caput, thorax, pelvic, and leg shock absorbers to place the patients while prone ( Curley et al. , 2006, p. 419 ) . The end is to hold the patient positioned prone, with their shoulders, hips and lower limbs supported while their venters has room to stick out ( towards the bed ) and custodies can be tucked under the venters. The existent shock absorber will be difficult to set up, as every infirmary uses different positioning devices, nevertheless, I will offer the thoughts of slackly rolled covers or the Eggcrate stuff cut to the appropriate size. It will be documented if the patient has developed a force per unit area ulcer, and the ulcer will be staged harmonizing to National Pressure Ulcer Advisory Panel ‘s ( NPUAP ) description. The NPUAP ( 2007 ) established four phases of force per unit area ulcers. The first phase includes force per unit area sores that include non-blanchable inflammation, with integral tegument, normally over a cadaverous prominence. Phase two includes shoal, unfastened ulcers with a ruddy or pink pigmentation, without sheding of the tegument. Stage three ulcers include a full thickness tissue loss. Hypodermic fat is normally seeable at this phase and shedding may be present. In a phase four ulcer, the ulcer is stage three with seeable bone, musculus or sinew. A patient will stay positioned prone for 20 hours of the twenty-four hours and supine for 4 hours a twenty-four hours. The length of clip a patient is prone and supine will be recorded. Ongoing measurement will be done on all organic structure systems, including pneumonic and circulatory. Arterial blood gases will be obtained 1 hr prior to a patient being positioned prone and 1 hr after the patient has been prone. To maximise safety, staff will use bedside nurses and respiratory healers during chances for turning. The respiratory healer should be responsible for the unity of the tubing and turning the patients head, bedside nurse 1 shall be responsible for the turning of the shoulders, thorax and weaponries, and beside nurse 3 shall be responsible for the turning of the hips and legs. The prone positioning protocol that is attached as Appendix 1 which will be at the bedside of every patient for the nurses and respiratory healers to follow consequently.Datas AnalysisHarmonizing to Polit & A ; Beck ( 2008 ) , there are two wide categories of statistical trials, parametric and nonparametric. Parametric trials normally involve the appraisal of parametric quantities, require measurings on an interval graduated table, and presume that the variables for distributed usually for a population. These trials are frequently considered the most power and are normally preferred by research workers ( Polit & A ; Beck, 2008, p. 591 ) . Nonparametric trials do non gauge parametric quantities, normally used when the sample size is little or the information is considered non-normal. Figure 22.5 in Polit & A ; Beck ( 2008, p. 592 ) is a speedy mention for choosing bivariate statistical trials. Harmonizing to Polit & A ; Beck ( 2008 ) , the Fisher ‘s exact trial will be used to prove the significance of the differences in the two interventions ( Polit & A ; Beck, 2008, p. 601 ) . Fisher ‘s exact trial or x2 trial will be used to compare prone and supine groups in their baseline features and results that will be calculated on an single patient footing. Based on the categorical informations, such as the oxygenation of the patient, related to the arterial blood gases, I think a Fisher ‘s exact trial will be the best trial. The accidental extubation rate during bends will be calculated utilizing an exact binomial trial for comparing the rates of two Poisson procedures. For prone patients, Wald ‘s statistic, distributed as a qi square, will be calculated based on results evaluated after alterations in placement. The figure of staff utilized and the length of clip involved in the place turns will be analyzed utilizing signed rank trials such as a Wilcoxon rank trial. Once all information has been collected, synthesized and analyzed, the research will be drafted into a manuscript and submitted to the Pediatric Critical Care diary. Before the survey begins, it will be reviewed, and hopefully approved, by the IRB. Before a patient becomes a participant of the survey, written informed consent will be obtained from a parent or legal defender. Both female and male patients will be utilized, and the exclusion standard is entirely based on patient safety. The participants will be allocated to the prone and supine placement groups reasonably by utilizing random assignment. Complete decrease of prejudice can non be established because it will be impossible for the clinicians to non cognize whether or non their patient is positioned prone or supine. With the assorted placement protocols and adjustments with pressure-reducing stuffs, I hope to diminish the incidence of compromised tegument unity and uncomfortableness. This survey does non object, and encourages the usage of sedation and hurting medicines while the participants are automatically ventilated.

4 Recommendation Letter Samples That Get It Right

The Culture Diversity Theory For Nursing Essay - 1483 Words

The Culture diversity theory Providing culturally competent nursing care begins with having basic principle knowledge and effective training us a nursing student. Madeleine Leininger’s Theory of Culture Care Diversity and Universality defines nursing as a learned scientific and humanistic profession that focuses on patient care, experiences and creative thinking relevant to nursing and health care system. As nurse student in today’s society you will come in contact with a lot of cultural differences, but having basic knowledge of cultural diversity will be an advantage, and it’s significant for a nurse to understand the interaction of these cultural systems which enables nurses to become more effective in doing nursing assessment and serving as client advocates. The focus of the theory is toward developing new practices for nursing to meet diverse cultural needs and to provide culturally congruent nursing care. 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Argumentative Essay The Entitlement Issue - 1925 Words

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Prejudice and Descrimination free essay sample

This learning starts as early as the age of three. The mass media also teaches about stereotyping, not just for children but for adults as well. When inaccurate portrayals are a primary source of information about a minority group, they can lead to unfavorable stereotypes. (Feldman, 2010) Throughout history we have seen many examples of prejudice and discrimination. A well known example would be the Holocaust. During 1939 through 1945 Adolf Hitler was obsessed with clearing Germany of all foreign races including the Jewish population. Hitler believed that the Jewish citizens were keeping the country from prospering economically, politically, and socially. Because of this Hitler began to abolish German Jews and at the end of 1945 nearly six million Jewish people were murdered because of Hitler’s discrimination (RB 66). The Holocaust may have taken place more than fifty years ago in another country, but prejudice and discrimination is still alive today all over the United States. We will write a custom essay sample on Prejudice and Descrimination or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The September 11th terrorist ttacks have caused stereotypes, prejudice and discrimination to occur towards the Muslim religion. The Muslim religion follows the 6 Pillars of Islam, the last pillar is Jihad. Many Americans have the idea that Jihad means â€Å"Holy War† and that it is part of the Muslim religion to attack and terrorize other religions, when in fact Jihad means â€Å"The obligation to strive to spread the religion over the world†. Many religions also believe it is there duty to teach their religion, just how Christians have missionaries. Both of these examples show just how serious discrimination can be. How can the world diminish prejudice and discrimination? According to Robert S Feldman, psychologists have developed several strategies that have proved effective. The first is to increase contact between the target of stereotyping and the holder of the stereotype research shows that increasing the amount of interaction between groups can reduce negative stereotyping. The second is to make values and norms against prejudice more conspicuous. Just reminding people about the values they already hold regarding equality and fair treatment of others. Similarly, people who hear others making strong, anti-racism statements are subsequently more likely to strongly condemn racism. The third and most direct means of changing stereotypical and discriminatory values is providing information about the targets of stereotyping. Educate people to be more aware of positive characteristics of targets of stereotyping. (Feldman, 2010) Prejudice and discrimination is all around us. No one is born to discriminate. Parents, peers and even mass media are teaching children as young as three to discriminate towards various groups of people. History has shown us just how far one person’s prejudice can go. It starts out as a basic stereotype towards one group of people and evolves into hate and discrimination that takes years to stop. Fortunately psychologists have seen the damage of prejudice and discrimination and have found that increase contact, demonstrating positive values against prejudice, and education are ways to reduce it.

Thomas Eliot; (1185 words) Essay Example For Students

Thomas Eliot; (1185 words) Essay Thomas EliotT.S. Eliot was a very influential pessimist, always and constantly thriving onhis hatred of little things and his love life. Eliot was born in St. LouisMissouri 1888 ad. His parents were both writers and loved the arts, mosteffectively passing on the genes to their son. While growing up he learned manythings, his parents were extremely social and intellectual and they pushed himto achieve the highest of statuses. He went to college at Harvard University andthen moved to London to go to Oxford. He then became a citizen of England in1915. While in England Eliot held many jobs to keep the payments on his 5thfloor English apartment and his college tuition. Eliot quickly became popularwith Britain and was known as a great poet and a literal critic. Eliot is bestknown for two of his works: The Waste Land (1922) and The Love Song of J. AlfredPrufrock (1915). Actually the Love song is the beginning of the Waste Land. TheWaste Land is in 5 parts, so it is more of a story in poeti cal form. In the LoveSong, Eliot actually sounds a bit like a optimist, quite frankly though his own?waste land?steps in half way through. This is his only poetic work I like. We will write a custom essay on Thomas Eliot; (1185 words) specifically for you for only $16.38 $13.9/page Order now But it will never be at the top of any of my lists. In this ?song? , JAP (J. Alfred Prufrock) is writing a letter to his honey, the girl he is in love with. In this poem Eliot uses a lot of visual imagery, he is very good with hisadjectives and brings such a happy correlation of thought into a grim reality hewould call his ?Waste Land?. He talks of how : In the room the women comeand go Talking of Michelangelo. TLSJAP stanza 13 and 14 It has been my thoughtthat this may signify his ?type?. Eliot, again was an intellectual and thenso he would most likely hang out where the smart people were and get away from:Of restless nights in one-night cheap hotels And sawdust restaurant withoyster-shells: Streets that follow like a tedious argument Of insidious intent. stanzas 6-9 He actually gives the evidence to where he found his women, andhow he likes to stroll through the outdoors and ending up in places ofeloquence, and ?High Society?. Even though he had a medium amount of money. He was still accepted in places for lower pay because of his high intelligenceand the intelligence of his women. People enjoyed his company. He goes ontalking about how there will always be time for us referring to the love thatwhich he shares for her, and that there will always be time for things, butletting each other look at the joy as present and the escape from his ?WasteLand?. He goes on in stanza 37 48 telling how they would grow old together,while still with the people that surround them that they love so dearly. He thentells of how he ?knows? things and how life always goes (evidence ofrealism) in stanzas 49 54. Now here you can start to sense his pessimisticside shed a bit, talking of the: To spit out all the butt-ends of my days andways, And how should I presume? Stanza 60 61 Of course I guess you couldtake that as a repentance line but, I dont think so, lets go on. From stanzas70 86 it shows what I think is his deep side and talking as if he wereactually a Realist whi ch he probably was, at least to me. He humbles himself agreat deal , which is good , but talks of how things slowly fade , referring alot to his baldness and how age takes a toll on relationships. This is myfavorite part of the poem, because he brings you into his soul, not just lettingyou taste the action . I feel that this is how he lived life. Always leavingpeople to taste the good stuff around him but behind his eyes ly his brain andbehind his brain his heart and when his company least expected it, ?I couldsee him waving his hands and saying?, ?Come all! Come! Come!come and feelmy paincome and pity mecome and think I am humble..even though Idont care much of any of you.? That is the picture I get of JAP who is alsoEliot, in life, but yet his background, his unnoticeable conscience. In stanza87 98 he speaks of his anxiousness to ask people into his ?Waste land? ,his wanting to let them see his truth. Then he tries to cover for himself bysaying: Should I say: ?That is not what I meant at all, That is not it, atall.? stanzas 97 98 In stanzas 119 and finishing the poem at 131 he endsoff, sorry to say, in a pessimistic tone of self pity and morbidity. He talksabout his age weighing on his soul and never being what he wants to look like inthe eyes of others and his eagerness in death by saying: We have lingered in thechambers of the sea By sea-girls wreathed with seaweed red and brown Till humanvoices wake us, and we drown. stanzas 129 131 That is a great background onhow Eliot viewed life. Realistically and fading into the distance with lovemeaning nothing at all. Well, on to what is called T.S. Eliots ?WasteLand?. To brief you on my thoughts I very much dislike this poem for manyreason which will be laid out in the next couple paragraphs. The poem is simplya look in to the soul of Eliot, a man with great writing capabilities but usesthem for the pleasure of striking his enemy and hiding the truth without beingup-front, using stories of ancient myths in Germ an and Latin to convey hisapathy. Eliot throughout this whole poems loves to mock and scorn his ex-wife. .ue30bd1e82dbc70cf492bebbbad9f8307 , .ue30bd1e82dbc70cf492bebbbad9f8307 .postImageUrl , .ue30bd1e82dbc70cf492bebbbad9f8307 .centered-text-area { min-height: 80px; position: relative; } .ue30bd1e82dbc70cf492bebbbad9f8307 , .ue30bd1e82dbc70cf492bebbbad9f8307:hover , .ue30bd1e82dbc70cf492bebbbad9f8307:visited , .ue30bd1e82dbc70cf492bebbbad9f8307:active { border:0!important; } .ue30bd1e82dbc70cf492bebbbad9f8307 .clearfix:after { content: ""; display: table; clear: both; } .ue30bd1e82dbc70cf492bebbbad9f8307 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .ue30bd1e82dbc70cf492bebbbad9f8307:active , .ue30bd1e82dbc70cf492bebbbad9f8307:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .ue30bd1e82dbc70cf492bebbbad9f8307 .centered-text-area { width: 100%; position: relative ; } .ue30bd1e82dbc70cf492bebbbad9f8307 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .ue30bd1e82dbc70cf492bebbbad9f8307 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .ue30bd1e82dbc70cf492bebbbad9f8307 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .ue30bd1e82dbc70cf492bebbbad9f8307:hover .ctaButton { background-color: #34495E!important; } .ue30bd1e82dbc70cf492bebbbad9f8307 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .ue30bd1e82dbc70cf492bebbbad9f8307 .ue30bd1e82dbc70cf492bebbbad9f8307-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .ue30bd1e82dbc70cf492bebbbad9f8307:after { content: ""; display: block; clear: both; } READ: the forever shifting earth Essay?Her sexual desire he could not satisfy and whose love he cannot return.? T.S. Eliots Waste land. Page 98 by: James E. Miller. Jr. He uses manysexually explicit gestures in the writing because that was the only way hisfantasies could be metthrough writing. ?I think the man is sick, hesfull of crap!? Eric Paoletti But he reveals his hatred toward her in theselines: More sinned against than sinning , bruised and marred, The lazy laughingJenny of the Bard. (The same eternal and consuming itch Can make a martyr and aconsuming bitch) There is much more but as you can see not very appropriate atall. Again this man won a Nobel Prize and was loved by Americans and theEnglish. ?How on Earth did he achieve that Probably because that is whatthe world is hungry for. Explains acts of fantasizing date rape and the hatredof his wife that he loved so much in the Love Letter, than leading into divorce. Overall if you ask me, T.S. Eliot didnt need fame, fortune and the NobelPrize. He needed serious mental help and most importantly, the God he talked ofso vaguely throughout his writing. BibliographyT.S. Eliots Personal waste land. By: James E. Miller Jr. Copyright 1977Published by: The Penn. State University Press, University Park and LondonThomas Sterns Eliot (1888 1965)