Saturday, December 28, 2019

Awakening Study Guide - 1752 Words

Section 1: Due Wednesday, March 8 Chapter I 1. What does the parrot say? What does it mean? How might these comments foreshadow what will occur in the novel? 2. Describe Leonce Pontellier. Specifically describe his reaction to the parrot, how he speaks to his wife, and his reaction to Mrs. Pontelliers question about dinner. 3. Describe the Pontellier children. 4. What is the role of the quadroon? 5. Who is Robert Lebrun? What is his part in this story? Chapter II 1. Describe Edna Pontellier. What does she look like? Where is she from? Where does she live now? 2. What is Robert Lebrun like? What are his plans for the future? Do you think he will ever follow through with his plans? Why, why not? 3.†¦show more content†¦4. What new information did you learn about Mlle Reisz? Chapter XVII 1. The setting has changed. Where does the story take place now? 2. Leonce is angered when Edna tells him she went out. Why is he angry? 3. What does Leonce think Edna should do about the cook? 4. Why does Edna try to destroy her wedding ring? What change is taking place in her? Chapter XVIII 1. How does Edna feel about the house and her domestic chores? 2. How does Adele feel about her domestic chores? 3. Reflect upon the difference between the two women. 4. Compare and contrast the Pontellier marriage with the Ratignolle marriage. Chapter XIX 1. After her visit with Adele, what does Edna do about her domestic obligations? Does this surprise you? Give evidence as to why you think Ednas reaction is expected or not. 2. How does Leonce react to Ednas actions? 3. Of what does Chopin say Leonce is not aware? 4. What does Edna spend her time doing? Chapter XX 1. What does the neighborhood grocer think of Mlle Reisz? Why do you think he feels this way? 2. Describe the altercation between Victor Lebrun and the black woman. 3. The Lebruns comment that Edna looks better. Why do you think Edna looks healthier? Chapter XXI 1. Describe Mlle Reiszs apartment. 2. How does Mlle Reisz react to Ednas arrival? 3. Mlle Reisz says to Edna, To be an artist includes much; one must possess many gifts – absolute gifts – which have notShow MoreRelatedThe Awakening Study Guide9992 Words   |  40 PagesThe Awakening Study Guide CHAPTER 1 1. Explain how the parrot and the mockingbird are used to introduce this chapter. They provide disruptive sound images. The parrot is saying, â€Å"Go away! Go away! For Heaven’s sake!† The mockingbird whistles with â€Å"maddening persistence.† 2. Describe Là ©once Pontellier. He appears to be a successful New Orleans businessman. He is neat and orderly in appearance and has an impatient manner. He and his wife, Edna, and their two children are vacationing at Grand IsleRead MoreBehavioral Interventions Designed Reduce Sleep Difficulties1722 Words   |  7 PagesAbstract The purpose of this study to investigate behavioral interventions designed to reduce sleep difficulties in a child. Positive bedtime routines and sleep restriction were successful in eliminating bedtime disturbances and nighttime awakenings in a five-year-old child sleeping problems. Positive bedtime routines included activities such as brushing teeth, taking a bath, picking out pajamas, and reading a story. Sleep restriction involved reducing the number of hours the child slept. WhileRead More7 Signs You May Be Experiencing a Spiritual Awakening800 Words   |  4 Pages 7 Signs You May Be Experiencing a Spiritual Awakening The Signs of Spiritual Awakening the Importance of Self-knowledge Metamorphosis. Like a caterpillar changing into a colourful butterfly, a person who is going through the stages of an awakening will have a colourful and more meaningful life. As a person going through a spiritual awakening, you will undergo a deeper and higher level of self-knowledge and self-awareness. You will become more mindful of your life experiences and the lessonsRead MoreLeadership Definition830 Words   |  4 PagesHow would you define leadership? (250 words maximum) There are several ways to define leadership. A process that influences other people to achieve an objective and guides the company or community in a way to make it more coherent and cohesive is called leadership. We can also define leadership as a process of leading people in the right direction in order to achieve goals. Leaders apply leadership attributes such as values, knowledge and skills to implement this process in any organization. LeadershipRead MoreChickamauga. This essay is about Ambrose Bierces dark short story, Chickamauga.1398 Words   |  6 PagesChickamauga Ambrose Bierces Chickamauga is a disillusioned childs awakening. Literally, a six year old deaf boy is thrown into a most horrifically traumatic series of events. His story is relayed in the third person omniscient perspective through the eyes of the child as well as an elder. It takes place during the Civil War in a southern town. Chickamauga begins with the boys entrance into the forest where he goes to play solitarily. With him he carries a toy wooden sword with which he battlesRead MoreThe Adventures Of Huckleberry Finn And The Awakening1419 Words   |  6 Pagesthe nation by creating removed, impartial status of everyday life. In a bid to bring readers to be fascinated by their stories and to depict their character and the reader’s setting to life, Mark Twain in the adventures of Huckleberry Finn and the awakening by Kate Chopin used regionalism and in the same way, Henry James showed the reality of life in his story Daisy Miller. Mark Twain together with Kate Chopin were experts in crea6ting a regionalism-based America.Regionalism,not forgetting refers toRead MoreImproving Healthcare Within The Realm Of Healthcare976 Words   |  4 Pagescare recommendations, which included using the least amount of sedative as possible for a given patient to tolerate invasive ventilator therapy (Klompas et al., 2014). The intervention used to reduce the amount of sedation is called the spontaneous awakening trial (SAT). By reducing the number of days the patient requires ventilator therapy, this intervention, when coupled with a spontaneous breathing trial (SBT), allows care providers to assess a patient’s readiness for extubation daily. This reducesRead MoreImproving Healthcare Within The Realm Of Healthcare984 Words   |  4 Pagescare recommendations, which included using the least amount of sedative as possible for a given patient to tolerate invasive ventilator therapy (Klompas et al., 2014). The intervention u sed to reduce the amount of sedation is called the spontaneous awakening trial (SAT). This daily intervention is to be done during a spontaneous breathing trial (SBT) to assess if the patient is ready for extubation. This reduces the number of days the patient requires ventilator therapy, which further reduces the riskRead MoreBorn Into Families Without Great Wealth Or Notable Prestige1599 Words   |  7 Pagesfaith, Dante and Augustine incorporated their personal spiritual awakenings and ideas concerning the relationship between God and man. Although the work of Dante is not as autobiographical, as that of Augustine’s, their literary contributions revolve around similar central themes of salvation, grace, and love. In comparison, multiple people and moments shaped the lives of both men and guided their lives towards spiritual awakening and understanding grace. Overall, it is through their writings, weRead MoreThe Democrats And The Whigs Were Polar Opposites Essay1545 Words   |  7 PagesTime Period 4 Study Guide 1. The Democrats and the Whigs were polar opposites of each other and believed strongly in different aspects of the federal government, economy, and state. The Whigs were mainly a conservative group which believed in a strong active government that protected industry through tariffs and wanted internal improvements such as canals, railroads, and telegraph lines as well as to promote public education. The Whigs also favored both Northern and Southern manufacturing and agriculture

Thursday, December 19, 2019

Women s Rights Of Education - 1174 Words

Women’s rights in education have improved greatly since the early 1800s — when girls only learned skills that society believed would make them good wives and would be ostracized for wanting more in their education. Today, more women than men attend and complete their collage degrees. In the early 1800s education was mainly for middle and upper class citizens in America, and was for boys. Even thought both classes were educated it was in very different ways. In the North if you were a part of an upper class family for most of you education you would have a private teacher or tutor come to your house and teach you. After you finished your schooling at your house you would be sent away to a collage or a university. If you were part of a middle class family and were a boy you would be sent to a local school and would usually not go to collage. Although it was not popular for girls in this time to go to school to receive an education some families would send their daughters to dame schools. These dame schools were similar to kindergarten and there both boys and girls were taught simple reading and writing. After girls finished their schooling at dame schools they usually would leave school and would be taught skills such as sewing. But some girls, that were usually a part of the upper class, would have tutors come to their homes and teach them math and more writing so that they would be able to organize the house expenses when they got married. (The History of Women andShow MoreRelatedWomen s Rights : Women, Employment, Education, And Politics2645 Words   |  11 Pages Women in the United States have faced many inequalities between their families, employment, education, and politics. As a woman myself, I have seen the changes in how women are treated in today’s time, but there are some things that still have to be changed. A good amount of men have said before that women should be treated unequally due to their feminine aspects about themselves. Women are believed to be unqualified to take upon the position of a man in the workplace, there has to be a change inRead MoreThe Impact Of Public Education On The Advancement Of Women s Rights982 Words   |  4 Pages The role of public education in the advancement of women’s rights and ideas within Canada is incredibly influential. Contemporary public education brings together the guidance and wisdom of instructors with the modern ideology of Canadian youth to create a hotbed of political discussion. With the guidance of a feminist teacher, a classroom can be transformed into a politically savvy force, pushing for the progression of women within Canadian society. Through my studies and volunteer activities,Read MoreWomen s Education : An International Human Right Without Any Discrimination Based On Sex895 Words   |  4 PagesWomen`s education is an international human right without any discrimination based on sex or gender. It is necessary for identity social development and a means for a prosperous life. Constantly, the United Nations emphasized women`s education and set goals for its success with gender equality. Empowering women`s education is an essential element in growing societies that seek democracy and economic advancement. For the last decade, Palestinian women education had been the concern for several reasonsRead MoreWomen s Suffrage By Elizabeth Cady Stanton1582 Words   |  7 Pageslate 1800’s women were tired of being put on the back burner. Women were not able to vote, work certain jobs and some were not able to get a basic education. There were many political changes arising and women wanted to have a voice and take part of the process. Women wanted to be considered equal with the same opportunities as men. In the 1840’s the first women suffrage convention entitled Seneca Falls Convention took place some women thought that their view were too extreme. .Many women such asRead MoreWomens Suffrage in the 1800’s-19th Century Essay1190 Words   |  5 Pages Women, like black slaves, were treated unequally from the male before the nineteenth century. The role of the women played the part of their description, physically and emotionally weak, which during this time period all women did was took care of their household and husband, and followed their orders. Women were classified as the â€Å"weaker sex† or below the standards of men in the early part of the century. Soon after the decades unfolded, women gradually surfaced to breathe the airRead MoreWomens Movement Impact1449 Words   |  6 PagesThe Women s Movement, including the Women’s Rights Movement and The Women’s Suffrage Movement, had a significant impact on U.S history. In order to understand if the movement met the set goals, we must look at what the value of women is today. Politically, new laws and amendments were passed to support women and their rights. Socially, women became more respected and accepted. Economically, women were given more roles in society. Educationally, women were given more education and career opportunitiesRead MoreShould Women Be Treated Equal?1247 Words   |  5 Pagesno matter in what religion she believes in. Women around the world spend more hours a day working without pay than men do, and only 32% of national constitution protect a girls right to an education higher than elementary school. So, should women be treated equal to men? From the Turkish President s Recap Tayyip Erdogan s point of view, Women are not equal to men... it is against nature to put them on an equal footing. he says at the Women s Right s Conference, stunning the crowd. He then alsoRead MoreThe Vindication Of The Rights Of Women1369 Words   |  6 PagesWollstonecraft, The Vindication of the Rights of Women. To investigate this, I will first summarize her work and someone else s interpretation of it, then analyze the author, voice, message and significance, and finally analyze the two works to answer the question, What are the current ideas about your philosopher? How have their ideas influenced us today?. My first souce will be the primary source of the Vindication, and my secondary source will be Matilde Martin Gonzalez s interpretation of this workRead MoreEssay about Bell Hooks803 Words   |  4 Pages Is Education Equal? nbsp;nbsp;nbsp;nbsp;nbsp;The United States provides our society with the undeniable right to learn. The right to higher education is not limited to the middle and upper classes; it allows the less privileged, minorities, as well as both sexes, to receive an equal education. Two arguments which present interesting views on higher education are bell hookamp;#8217;s amp;#8220;Keeping Close to Home; and Adrienne Richamp;#8217;s amp;#8220;What Does a Woman Need to KnowRead More A Vindication of the Right of Women and Woman in the Nineteenth Century1387 Words   |  6 PagesEducation of Women in A Vindication of the Right of Women and Woman in the Nineteenth Century      Ã‚  Ã‚  Ã‚   In two centuries where women have very little or no rights at all, Mary Wollstonecraft and Margaret Fuller appear as claiming voices, as two followers of feminism. Two women separated by a century but united by the same ideals. In these male- dominated societies, these two educated women tried to vindicate their rights through one of the few areas where they could show their intelligence: literature

Wednesday, December 11, 2019

Scientific and Clinical Evidence of Pacemakers †MyAssignmenthelp

Question: Discuss about the Scientific and Clinical Evidence of Pacemakers. Answer: Introduction In 1950's, Elmquist and Senning at the Karolinsika Hospital, Stockholm, successfully implanted the first ever epicardial system by thoracotomy [1]. Since then, substantial improvements have been made in pacemaker technology, leading to highly sophisticated, entirely endocardial, transvenous systems. Over the past years, the rate of pacemaker implantation has accelerated to approximately 700,000 per year [2]. The same studies show that in United States of America (USA) the implantation rate per year is 250,000, in Europe, implantation rate in 18 countries stands at 938 units per million of the residents annually. Population aging and great suggestions for the implant of the CIEDs (cardiac implantable electronic devices) are the primary reasons for the progressive increase of the CIDs, PMs, and tools for the CRT [3]. The latest statistics show that since 2005 to 2008, the rate of CIEDs implants have significantly increased, particularly in European countries, with a higher demand for ICDs than for PMs [4]. Despite the progress, pacemaker therapy is still associated with non-negligible peri and post-procedural complications, with transvenous lead remaining the major challenge in the pacing technology [5]. Many implantation processes may result in complications such as pneumothorax, lead dislodgement, cardiac perforation, and tamponade, among other impediments. Complications such as venous thrombosis, significant regurgitation of the tricuspid valve are usually associated with lead pacemaker's implantation [6]. Also, first failure due to insulation problems, the first fracture was reported to be 13% of the total patient who underwent first pacemaker implantation [7]. Modern technological advancement such as leadless pacemaker system, which is implantable in the right ventricle is a significant step towards reducing pacemaker lead-related complications. Materials and designs At present, only two types of leadless pacing systems are available; the NanostimTM Leadless Pacemakers System (LCP) introduced in 2012, and the MicraTM Transcatheter Pacing System (TPS) launched in 2013 [8]. Although both systems have received a CE mark, only Micra-TPS is approved for use in the USA by FDA (Food and Drug Administration). Both systems are entirely intracardiac having the generator, the pacing and sensing electrodes incorporated into a capsulated partition implanted straight in the right ventricular wall [9]. The cathode, located on the distal end in both systems is steroid eluting, suitable for reducing inflammation. In the Micra-TPS, the anode is made of titanium ring in the proximal part of the case, while on the Nanostim-LCP, the nearly entire surface can function as an anode. The features of both devices are displayed in Table 1 [10]. After selecting the target region for implantation, the Nanostim-LCP is tightened by rotation, while in the Micra-TPS, tightening is done by retraction of the outer sheath and, hence fixing the pacemaker in place [11]. Liberation of the pacemaker from the delivery catheter then follows, though there is still a connection through tethering mechanism. This allows for testing of both pacemaker parameters (sensing, threshold testing, and impendence) as well as stability. Once the sensing and pacing parameters are satisfactory, the system is finally released from the delivery catheter as illustrated in figure 1 [12]. Table 1 . Features of currently used leadless pacing systems. Micra ( TPS ) size (mm) capacity(cm3) 25.9 6.7 0.8 Weight (g) 2 Sheath size (French) 23 Fixation mechanism Nitinol-tines Polarity Bipolar Pacing mode VVI- VVIR Rate-responsive sensor Accelerometer Battery Lithium silver vanadium oxide/carbon Estimated battery longevity Monofluoride Standard 9.8 settings ( y ) 4.7 Alternative 14.7 settings ( y ) 9.6 Telemetry SJM, Model 3650 Medtronic, Model 2090 Option for retrieval Yes Yes LCP: Leadless Pacemaker System, TPS: Transcatheter Pacing Clinical safety and efficacy of the leadless pacemakers The LEADLESS trial research about the effectiveness and safety of the Nanostim-LCP was the first study was done that was capable of showing results in humans [13] LEADLESS in itself is a potential, systematic, multicenter trial that was performed in three countries in Europe from December 2012 to April 2013. Patients are showing signs of cardiac pacing, for instance, permanent atrial fibrillation, coupled with atrioventricular block, a reasonable range of sinus beat with either second or third-degree atrioventricular block with a reduced level of physical activity were considered for the research [14]. Thirty-three patients of an average age of 82 were recruited for this study, and the participants each received Nanostim-LCP system [15]. The participants were followed-up for the 2nd, 6th and 12th week following implantation of the Nanostim-LCP system. The safety target for the study was that the participants should be safe from adverse effects of pacemaker implantation after 90 days following implantation. Secondary performance outcome was based on the implants success rate, implant time and features of implant performance such as the threshold of pacing and racing, batter longevity, and rate responsive performance [16]. Based on the results, implantation success rate was recorded at 97% with 32 out of the 33 patients completing the studies. The procedure duration was averaged at 40 minutes. Ten patients who took part in the survey required repositioning of Nanostim-LCP, translating to 30% of the total patients. Complication free rate was recorded at 94%, taking into account 31 out of 33 patients. However, two serious issues were reported, a 70-year-old patient who experienced cardiac tamponade and right ventricle perforation was complicated with an ischemic stroke on the 5th day following implantation and succumbed to death In th e second patient, implantation was performed on the LV (left ventricle) via a persistent foramen ovale. Throughout the entire process, no lead dislodgement was encountered [17]. The mean R-wave amplitude was 8.3mV, pacing threshold of 0.80V at 0.4-ms pulse width and impedance of 773Ohms was reported at implantation, and three months later, the parameters either remained stable or improved. After the 12 months follow up period elapsed, the average R-wave amplitude, impedance, mean pacing threshold was 10.3mV, 627Ohms, and 0.43V( at a 0.4-ms pulse width), respectively. Also, it was noted that after the 12 months, there was no complication related to the Nanostim-LCP device and battery exhaustion cases [17]. Based on the systematic randomized results of the LEADLESS trial, it can be deduced that safety and efficacy of the patient following leadless pacemaker system implantation are significantly improved and be a suitable alternative to the standard pacemakers. Unfortunately, due to the death of the patient because of cardiac tamponade, implementation of the leadless pacemaker system in the clinical field was temporarily paused. Later on, permission was granted following training of the physicians carrying out implantation [18]. LEADLESS II study (prospective, nonrandomized, multicenter trial) is underway. The research focuses on the clinical safety and efficacy of the Nanastim-LCP implantation in patients that need permanent single-chamber ventricular pacing [19]. The provisional outcome of the investigation that was recently reported consist of 527 patients who were recruited from 56 sites in the three European countries. The LEADLESS II consisted of subjects that were enrolled from February 2014 to June 2015. Based on the interim results, the success rate was at 95.8% representing 504 of 527 participants [19]. Implantation time took an average of 50 minutes. The primary cohort consisted of 300 patients, who were followed-up for six months. The provisional result reported 2.0V (at 0.4ms) and sensed amplitude 5.0mV following six months, which are both above the standard range. The primary objective was that the patients should be safe from pacemaker device associated complications through the six months [19]. Significant adverse cases occurred in 6.5% of the total participants that included ventricular perforation, hemopericardium without the need of intervention, and pericardium tamponade requiring intervention. Device dislodgement was reported in 6 patients representing 1.5% of the subjects, in 4 cases, the devices migrated to the pulmonary artery, while in the remaining two patients, the invention migrated to the femoral vein. In all the 6 cases, the dislodged devices were successfully recovered. Vascular access complications were reported in 1.2% of the patients [20]. Prospective, nonrandomized, single group, multisite, international clinical study about the Micra Transcatheter Pacing System was carried in 19 countries globally. The purpose of the study was to evaluate the pacing performance of the system. Seven hundred and twenty-five patients underwent Micra-TPS implantation attempt carried at 56 sites within the countries [21]. The success rate of the Micra-TPS implantation was recorded at 99.2%, translating to 719 patients out of the total 725 subjects. Over the duration of the six months, significant complications rate was reported at 4% as compared to the 7.4% in the control group (hazard ratio 0.50, 95% CI(Confidence Interval) 0.33 to 0.75, p=0.001). The intervention group (underwent Micra-TPS implantation) consisted of older patients with comorbidities as compared to the control group (historical cohort). The decline of device-related complications in the intervention group was even much more evident when a matched unit was used for compar ison [21]. The 4% complication rate was composed of 1.6% cardiac perforation, 0.7% access associated issues, 0.3% those with venous thromboembolism and 0.3% representing an increase in threshold stimulation in spite of an absence of dislodgement. Metabolic acidosis led to the death of one patient due to sepsis and renal failure. There were no cases of device-related complications. Regarding pericardial effusion, the intervention group reported 1.6% as compared to the 1.1% in the control group. However, the difference is statistically negligible. There were no cases of lead-related issues or device pocket infection which resulted in the lower rate of complication in comparison to the conventional intravenous pacemakers [21]. Electrical measurement done after six months, included intra-cardiac signal amplitude, stimulation threshold, and pacing impedance which either remained stable or improved in 98.3% of the patients. Comparison of the two results is displayed in table 2. In summary, the in LEADLESS II Nanostim-LCP, the success rate of implantation was 95.8% representing 504 of the 526 patients. Implantation time took an average of 50 minutes. Primary efficacy following the six months was achieved in 270 patients of the total 300 patients (90%). Since the Nanostim-LCP implantation was unsuccessful 6.6% (270 of 289 patients), the primary met the end point (93.4%). Additionally, central safety endpoint was achieved in 280 out of the 300 participants (93.3%). Following six months, 6.7% of the patients experienced adverse effects, which constituted of 1.3% cardiac perforation, 1.7% device dislodgement with successful percutaneous withdrawal, 1.3% elevation in pacing threshold which needed device retrieval or replacement. The battery longevity approximation in LEADLESS Nanostim-LCP study was 15 years. Variables Trials Leadless II-LCP (n526) Micra-TPS (n725) Implant Success 95.8% 99.2% Thresholds @ Implant V@ms) 0.82 @ 0.4 0.63 @ 0.24 Threshold @ 6 Months V@ms ) 0.53 @ 0.4 0.54 V @ 0.24 Complication Rates (6 months) 6.5% 4% Pericardial Effusion 1.5% 1.6 % Groin Complication 1.2% 0.7 % Device Dislodgement 1.1% 0 % In the Micra Transcatheter pacing study, the success rate of device implantation was 99.2%, translating to 719 out of the 725 patients. Adverse complications were reported in 25 of the725 patients, with no evidence of device dislodgements. Control group recorded significantly higher number of complications (7%) as compared to the 4% of the intervention group. Significant complications reported include five groin puncture complication, 11 cardiac injuries, two thromboembolism issues, two pacing cases and eight general complications [22]. The rate of efficacy over the six months was 98.3% in 292 out of 297 patients followed up within the period. Battery life approximations following six months were 12.5 years. Therefore, it is evident that the results from the two studies, even though is a short-term data, reveal that leadless pacing system is a safer and more efficient alternative to conventional lead intravenous pacemakers [22]. Based on the interim results from clinical evaluation, there is a possibility of the leadless pacing gaining widespread adoption. This mainly depends on the practicability and ease of multi-chamber leadless stimulation. This is because the primary limitation of the leadless pacemakers is that they can be used single-chamber ventricular pacing [23]. Therefore, it may not be suitable for patients with sinus-node dysfunction and other conditions, who require multi-chamber pacing system. Long-term research is necessary to confirm the device performance regarding battery longevity, adequate sensing, the safety of retrieval, stable stimulation control, among other parameters. The two types of research also do not explain the destiny of the devices after reaching the end of service. They do not clarify whether the devices will be switched off, or retrieved during replacement implantation. Finally, the cost of the leadless pacemakers is much higher than that of the conventional pacemakers. H ence, many people cannot afford them. Conclusion Based on the research results and the early experience of first-generation leadless pacemakers, there is more potential to explore using this novel technology. The reduction of the device related complications gives leadless technology a favorable advantage. The introduction of the leadless technology in healthcare facilities present a promising future in dealing with cardiovascular complications. However, the first generation leadless pacemakers require further technological advancement for development of the dual-chamber pacing system. Also, randomized, the clinical trial is necessary to further determine the long-term safety, efficacy, and retrievability of the leadless pacing system. Regardless of the concerns, the preliminary results about the performance of the leadless pacing system are quite impressing, making the new technology an additional weapon in clinical practice. The technology is ideal for patients with complicated venous anatomy as well as patients in whom implantat ion of the conventional lead system is impossible. References Jacobson, P.M., Pacesetter, Inc., 2016. Leadless cardiac pacemaker. U.S. Patent 9,358,400. Ritter, P., Duray, G.Z., Steinwender, C., Soejima, K., Omar, R., Mont, L., Boersma, L.V., Knops, R.E., Chinitz, L., Zhang, S. and Narasimhan, C., 2015. Early performance of a miniaturized leadless cardiac pacemaker: the Micra Transcatheter Pacing Study. European heart journal, 36(37), pp.2510-2519. Knops, R.E., Tjong, F.V., Neuzil, P., Sperzel, J., Miller, M.A., Petru, J., Simon, J., Sediva, L., de Groot, J.R., Dukkipati, S.R. and Koruth, J.S., 2015. Chronic performance of a leadless cardiac pacemaker. Journal of the American College of Cardiology, 65(15), pp.1497-1504. Miller, M.A., Neuzil, P., Dukkipati, S.R. and Reddy, V.Y., 2015. Leadless cardiac pacemakers: back to the future. Journal of the American College of Cardiology, 66(10), pp.1179-1189. Reynolds, D., Duray, G.Z., Omar, R., Soejima, K., Neuzil, P., Zhang, S., Narasimhan, C., Steinwender, C., Brugada, J., Lloyd, M. and Roberts, P.R., 2016. A leadless intracardiac transcatheter pacing system. New England Journal of Medicine, 374(6), pp.533-541. Reddy, V.Y., Exner, D.V., Cantillon, D.J., Doshi, R., Bunch, T.J., Tomassoni, G.F., Friedman, P.A., Estes III, N.M., Ip, J., Niazi, I. and Plunkitt, K., 2015. Percutaneous implantation of an entirely intracardiac leadless pacemaker. New England Journal of Medicine, 373(12), pp.1125-1135. Ostroff, A., Pacesetter, Inc., 2016. Leadless cardiac pacemaker with secondary fixation capability. U.S. Patent 9,272,155. Kypta, A., Blessberger, H., Lichtenauer, M. and Steinwender, C., 2016. Complete encapsulation of a leadless cardiac pacemaker. Clinical Research in Cardiology, 105(1), pp.94-94. Koruth, J.S., Rippy, M.K., Khairkhahan, A., Ligon, D.A., Hubbard, C.A., GOAR, F.S., Lee, R., Ribeiro, L., Miller, M., Dukkipati, S. and Neuzil, P., 2015. Feasibility and efficacy of percutaneously delivered leadless cardiac pacing in an in vivo ovine model. Journal of cardiovascular electrophysiology, 26(3), pp.322-328. Sperzel, J., Burri, H., Gras, D., Tjong, F.V., Knops, R.E., Hindricks, G., Steinwender, C. and Defaye, P., 2015. State of the art of leadless pacing. EP Europace, 17(10), pp.1508-1513. Garweg, C., Ector, J. and Willems, R., 2016. Leadless cardiac pacemaker as alternative in case of congenital vascular abnormality and pocket infection. EP Europace, 18(10), pp.1564-1564. Tjong, F.V.Y., Brouwer, T.F., Smeding, L., Kooiman, K.M., de Groot, J.R., Ligon, D., Sanghera, R., Schalij, M.J., Wilde, A.A.M. and Knops, R.E., 2016. Combined leadless pacemaker and subcutaneous implantable defibrillator therapy: feasibility, safety, and performance. EP Europace, 18(11), pp.1740-1747. Jacobson, P.M., Pacesetter, Inc., 2015. Rate responsive leadless cardiac pacemaker. U.S. Patent 9,072,913. Gold, M.R., 2015. Are leadless pacemakers a niche or the future of device therapy? Seriwala, H.M., Khan, M.S., Munir, M.B., Bin Riaz, I., Riaz, H., Saba, S. and Voigt, A.H., 2016. Leadless pacemakers: a new era in cardiac pacing. Journal of cardiology, 67(1), pp.1-5. Sharma, D., Miller, M.A., Palaniswamy, C., Koruth, J.S., Dukkipati, S.R. and Reddy, V.Y., 2015. The Leadless Cardiac Pacemaker. JACC: Clinical Electrophysiology, 1(4), pp.335-336. Bonner, M., Eggen, M., Haddad, T., Sheldon, T. and Williams, E., 2015. Early performance and safety of the micra transcatheter pacemaker in pigs. Pacing and Clinical Electrophysiology, 38(11), pp.1248-1259. Boink, G.J., Christoffels, V.M., Robinson, R.B. and Tan, H.L., 2015. The past, present, and future of pacemaker therapies. Trends in cardiovascular medicine, 25(8), pp.661-673. El-Chami, M.F., Merchant, F.M. and Leon, A.R., 2017. Leadless pacemakers. The American journal of cardiology, 119(1), pp.145-148. Hastings, R., Sadasiva, A., Pikus, M.J. and Kveen, G.L., Cardiac Pacemakers, Inc., 2017. Leadless cardiac stimulation systems. U.S. Patent 9,545,513. Da Costa, A., Axiotis, A., Romeyer-Bouchard, C., Abdellaoui, L., Afif, Z., Guichard, J.B., Gerbay, A. and Isaaz, K., 2017. Transcatheter leadless cardiac pacing: the new alternative solution. International journal of cardiology, 227, pp.122-126. Wiles, B.M. and Roberts, P.R., 2017. 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Wednesday, December 4, 2019

Slept Analysis free essay sample

Social Social factors relate to pattern of behavior, taste and lifestyles. The influence that social factors have on the growth of mobile phone industry in Africa is vital. The number of mobile phone users in Africa has increase tremendously over the past decade from a mere 72,000 (excluding South Africa) to an astounding 25. 5 million users. * Safety and Convenience The safety and easy accessibility of mobile phones has prompted many Africans to use them. The use of mobile phones to deliver message is a safer way compared to he conventional mail method which is exposed to risk of mail lost or important information falling into the wrong hands. Mobile phone is now one of the most effective and efficient mode of communication in the world. * Demographics According to McKinney None 2010), the number of working-age population will increase from 500 million today to 1. 1 billion in 2040. This indicates that the mobile phone industry will be growing substantially in the future due to the increasing number of the population with ability to afford the use of mobile phones and it is classically a necessity for this group of population. We will write a custom essay sample on Slept Analysis or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page B) Political/Legal The government plays a major role in encouraging or discouraging the growth of mobile phone industry in certain countries. The main barrier to further expansion remains the troublesome regulatory framework where countries with similar economic circumstances but with a liberalized market generally show higher penetration rates. Regulations Taxes can also deter the expansion of m-bile phone industry such as import duties on handsets or special communications surcharges. Infrastructure In most countries, the mobile phone industry acts as a huge source of income to the government who have used its popularity for generating tax revenues but did not invest the money gained in improving the infrastructure to support the growth. In order to build additional infrastructure to support the network, it usually requires a certain approval from some government entity and statutory bodies to use their lands. Due to these constraints, rural and remote areas will not be able to gain coverage due to the lack of infrastructure and this will affect he ability of telecommunication companies to expand to such areas. * Health Issues Health issues due to the closeness of phone masts to residential and public areas is still an issue to most countries and there is still no definitive public opinion on the effect of mobile phone usage by people. ) Economic t- The cost to using mobile services in Iatric is relatively nigh such as making calls and sending texts plus the huge population of Africa still lives in poverty and might not be able to afford such services. As stated in the article, running a mobile hone costs the average user 3 percent of a monthly income in South Africa and even more in countries like Kenya, Tanzania, Rwanda and Niger which are approximately 25 to 60 percent. This will withhold the growth of the mobile phone services market into certain markets in Africa. D) Technological * Innovation One of the main technological factors that influence the growth of mobile phone in Africa is the existence of mobile internet technology. In this era of information technology, the innovation of mobile services has sprouted the growth of bile phone industry and as mentioned in the article, mobile banking has been one of the factors. The people of Africa are now opting for conveniences and hassle-free online transactions as everything could be done anywhere, anytime. The use of mobile phone enhances communication flow as well. This is due to the fact that with mobile telecommunications, messages can be passed on to another party in matter of seconds. Moreover, more things such as paying utility bills could be done in a shorter time period compared to conventional methods.