Beginning and Ending Supportive Therapy

Question: Discuss about the Beginning and Ending Supportive Therapy. Answer: Introduction: Acute kidney injury is an illness that is depicted by sudden loss of the ability of the kidney to filter out waste from the body. This condition is characterized by compiled end products that consist of urea and creatinine. The patient had been diagnosed to have a low urine output, increased metabolic acids in the body and having high levels of phosphorus and potassium in the system (Bagshaw, 2009). The physical assessment included evaluation of fluid status that depicted the final information from the albumin and saline reaction that gave the comparison in saline that was isotonic- reaction of four percent albumin in the patient and 0.9% of normal saline, signs of acute and chronic heart failure, infections present and drug history of the drugs recently used. Recent blood transfusion, if the patient had undergone any surgical procedure, the patient had lost weight and he was dehydrated. The blood pressure of the patient had also decreased significantly over two weeks period. The patient also depicted blueish finger tips, and had swellings in the lower back (Uchino, 2007). Acute kidney failure is commonly caused by a variety of causes. It can occur if the patient has a condition that reduces the pace of blood flow in the body, if the kidneys are damaged and if the ureters are clogged and thus hampering the release of waste from the body. Blood flow in the body can be hampered by reduced blood in the body, failure of the liver, if one is severely dehydrated, if one has used medications such as naproxen, heart attack and infections of the heart. The kidneys can be damaged if there are clots of blood in the body, kidney blockage due to high levels of cholesterol in the body, swelling of the kidneys, utilization of chemotherapy drugs, indulgence in alcohol consumption and inflammation of the blood vessels (Waikar, 2009). Clinical priorities that are important to patients suffering from acute kidney injury include rehydration this implies that the patients blood pressure is less than a hundred mmHg and they should be administered with a bolus of 250ml of crystalloid. They can also be checked to see if their ureters are blocked. The patients should also cease utilization of nephrotoxic medications. Urinalysis should also be performed on the patient and intensify as per the medication policies (Tumlin, 2008). The goals of the patient were: he wanted to heal quickly so that he could fend for his family, the patient desired that he could regain his lost weight and he desired to have his normal finger tips without the bluish appearance. Interventions performed on the patient were: controlling his blood sugar, he was rehydrated too so that the fluid levels in the body could increase. Nursing care that the patient received included administering of excessive fluids, reduction of the risk of unconventional nutritional guide, reduction of the chances of being infected, impacting of the patient with the relevant knowledge about the disease and reduction of the risk of having a cardiac arrest. Medical intervention provided included the rectification of the high acid with administration of a bicarbonate and rectification of defects of hematologic properties anemia. References Bagshaw SM, Uchino S, Bellomo R, et al. Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators.. J Crit Care2009 Uchino S, Bellomo R, Kellum JA, and the Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney). Int J Artif Organs Tumlin J, Wali R, Williams W, et al. Effi cacy and safety of renal tubule cell therapy for acute renal failure. J Am Soc Nephrol 2008 Golestaneh L, Melamed DL, Hostetter TH. Uremic memory: the role of acute kidney injury in long-term outcomes. Kidney Int 2009

Technologys Effect on the Acquisition of Knowledg Essay Example For Students

Technologys Effect on the Acquisition of Knowledg Essay eFor a class called Theory of Knowledge. As I walked into my younger brothers elementary school one day to pick him up, I was confronted with a flurry of sounds; it was nothing new, this was just the first time that I noticed it. All I heard was the buzzing of computers, the ringing or phones and the humming of printers. The same at my school, my parents workplaces, and nearly every other public place, as well as some private places. Then I began to wonder if all of these technological advances really help, or rather hinder, how we gather information from the world around us. We will write a custom essay on Technologys Effect on the Acquisition of Knowledg specifically for you for only $16.38 $13.9/page Order now Do these smaller and faster computers, these increasingly tiny cellular phones, or any of these other recent technological inventions really expand the acquisition of knowledge? Or are we just moving backwards?First of all, I think that we need to define technology. My definition, as well as the definition that I will use to determine whether something is technology, is any device that makes life easier for the people who possess and use it. One of the most obvious ways is that now it is a lot easier to access knowledge. You can research any topic and access statistics and primary documents. You have got the world at your fingertips. I, as an International Baccalaureate student, cannot imagine writing papers or researching any issue without access to the Internet. Another example of technology that helps most people is the calculator. I cannot even imagine trying to do Calculus homework without its help. With the aid of the calculator, you need not look up or calculate by hand values such as logarithm, sine or cosineit is just beyond me how they did complicated math like that before everyone had calculators. Another advantage is that, if you have Internet access at home, you have access to seemingly endless information twenty-four hours a day and seven days a week; anytime you want to learn something about any theme, you can. Even devices such as overhead projectors and loudspeakers make access to knowledge easier. Also, as technology progresses, computers get more affordable, along with other learning tools, thus they become available to more people. There is also more information. Examples include movies, photos, audio devices and other entertainment that was not available before. There is also more scientific equipment that allows us to collect more information about the world such as the transition electron microscope, which allows us to examine the inside of cells, and the technology that allows us to carbon date fossils and such. Technology also makes learning a lot more fun. Computer programs such as Word Muncher and Number Muncher help children with vocabulary and math skills, telling them a certain kind or word to eat or gives them a word such as prime and they must find and eat all prime numbers before they get eaten by these little monsters. I learned a lot from these programs, and I see my little brother, who is in second grade, doing the same. He also likes to play a game called Pre-Kindergarten which gives him a colorful certificate if he does well. A program provides visually stimulating colors and rousing sounds that flashcards and textbooks cannot. They allow children to learn things about a variety to topics while captivating them, which can be hard to do. I, personally, have seen my brother greatly benefit from these programs. He also loves to watch movies and television programs that show Barney and Thomas the Train solving the math problem or inserting the missing letter into words. He plays those games and watches those programs for hours on end. .ue921a9f47182158a416a013d1ffcde8c , .ue921a9f47182158a416a013d1ffcde8c .postImageUrl , .ue921a9f47182158a416a013d1ffcde8c .centered-text-area { min-height: 80px; position: relative; } .ue921a9f47182158a416a013d1ffcde8c , .ue921a9f47182158a416a013d1ffcde8c:hover , .ue921a9f47182158a416a013d1ffcde8c:visited , .ue921a9f47182158a416a013d1ffcde8c:active { border:0!important; } .ue921a9f47182158a416a013d1ffcde8c .clearfix:after { content: ""; display: table; clear: both; } .ue921a9f47182158a416a013d1ffcde8c { 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; } .ue921a9f47182158a416a013d1ffcde8c:active , .ue921a9f47182158a416a013d1ffcde8c:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .ue921a9f47182158a416a013d1ffcde8c .centered-text-area { width: 100%; position: relative ; } .ue921a9f47182158a416a013d1ffcde8c .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .ue921a9f47182158a416a013d1ffcde8c .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .ue921a9f47182158a416a013d1ffcde8c .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; } .ue921a9f47182158a416a013d1ffcde8c:hover .ctaButton { background-color: #34495E!important; } .ue921a9f47182158a416a013d1ffcde8c .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .ue921a9f47182158a416a013d1ffcde8c .ue921a9f47182158a416a013d1ffcde8c-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .ue921a9f47182158a416a013d1ffcde8c:after { content: ""; display: block; clear: both; } READ: For International Baccalaureate Language Essay I way I know these effects through perception and emotion. I perceive the way that my brother has benefited from using technology; he is learning without knowing it and while having fun. I am pleased that I have access to computers and other technological devices that have helped me through school and through life.However, on the other hand, technology can sometimes limit the acquisition of knowledge. Einstein once said, It has become increasingly obvious that our technology has exceeded our humanity. Because of technology there is, for

Ziggurat at Ur, c. 2100 B.C. essays

Ziggurat at Ur, c. 2100 B.C. essays Ziggurats are a form of ancient temple common to the Sumerians, Babylonians and Assyrians. A Ziggurat is a huge platform with a series of smaller platforms on top. They look like a stepped pyramid with stairs leading to the summit where there was a small temple. Each ziggurat was dedicated to the city's most important god or goddess. Ziggurats are like a mud-brick mountain fit for the gods. Around 2100 B.C. king Ur-Nammu built a ziggurat in honor of the God Sin. It was called Etemennigur, which meant a house whose foundation creates terror. It was built in Ur, south of Iraq and has been visible on the flat Mesopotamian plain for thousands of years. The ziggurat was built from small mud bricks that were locally produced. The mud bricks were made out of mud and reed; the reed was pressed into moulds that had been left to dry in the sun. Each brick measured around 25 x 16 x 7 centimeters and weighed around 4.5 kilograms. The core of the ziggurat at Ur was constructed using mud bricks which were then covered with baked bricks. The baked bricks, which measured about 30 x 30 x 7 cm and weighed up to 15 kg, they were made out of clay pressed into moulds. The bricks were left to dry and were then baked in a mud oven using dry twigs which were set on fire. This made the bricks water resistant. The first stage of the ziggurat was built using around 7,000,000 mud bricks And 720,000 baked bricks. On top of every sixth layer of bricks, reed matting was placed in a criss-cross manner. Sandy soil was also placed with the layer of reeds. Most of the bricks were stamped with the name and title of King Ur-Nammu. The base of the temple was either square or rectangular, and the most common size for it was either 50x50 or 40x50 meters. From the base, new steps were added, until the ziggurat was topped by a small sanctuary. All walls were sloping, and all horizontal lines ...

Equal Rigths Amendment Essay Example | Topics and Well Written Essays - 2000 words

Equal Rigths Amendment - Essay Example Gender based discrimination could also be observed in other social aspects. It was also seen screaming on the political front where women weren’t allowed to cast a vote and participate in the formulation of a democratic government. In the mid-nineteenth century, feminists(Gill)were the first to start the movement for the abolition of inequality from society. In this regard first planned meeting was arranged by the Women’s Rights Convention under the supervision of Elizabeth Candy Stanton and Lucretia Mott in Seneca Falls(Neale). This meeting was 2 days long and approximately 300 men and women participated.During the course of discussions, Alice Paul introduced the Equal Rights Amendment as(Francis): â€Å"If we keep on this way they will be celebrating the 150th anniversary of the 1848 convention without being much further advanced in equal rights than we are†¦. If we had not concentrated on the Federal Amendment we should be working today for suffrage†¦. We shall not be safe until the principle of equal rights is written into the framework of our government.† The purpose of this meeting was to raise a voice against injustice suffered by women in the male oriented society, which mercilessly made them a victim of ridicule and disrespect. Congress was later informed about the meeting and a request was put forward that asked for the ratification of equal rights for both men and women, and inclusion of this clause in the constitution. This effort received strong opposition from men, as well as a few women, who were against the notion of women standing at equal footing with men. In fourteenth amendment of the constitution, congress appalled all the workers of feminist movement by paying heed to their endless requests and introducing the equality clause in the constitution. According to the amendment, all the citizens of U.S have the equal rights. The word â€Å"male† was introduced for the first time in the constitution while ta lking about the electorate rights that still granted the voting ability to only the men of the country. Susan did not accept the exemption of women from the right to vote and therefore went to cast vote in presidential elections. As a result of this act, she was fine, arrested and convicted with this apparent crime. When this case was taken to the Supreme Court, it was decided that although women were very much citizens of the country, it was not necessary for every citizen to have the right to vote. Fourteenth amendment could not suppress this effort and the campaign for human rights continued for many years thereafter. Stanton, Susan, and Sojourner also fought to abolish slavery and demanded equal rights for the slaves. Stanton and Frederick made many impassioned speeches, urging the authorities to grant females the right to cast a vote in their country. This resulted in the Amendment of suffrage which was introduced in the constitution and supported women’s right to vote. Just after three years of the ratification of suffrage amendment, National Women’s Party forwarded an equal rights amendment to the Congress, which was ratified for years in every part of the country since 1923. This document has passed through different phases and was amended a number of times and finally got placed in the national constitution in much modified form. It was incorporated officially into the

Political Philosophy Essay Example | Topics and Well Written Essays - 2000 words

Political Philosophy - Essay Example Many people have questioned whether the government, with all its laws and regulations, is justified to rule the people. What right does the government have to demand that its people obey? Why should an individual obey the state in the first place? These are just a few of philosophical queries being asked. Nonetheless, a majority of the responds stress the need for an orderly process and protection as the justification for obedience to the government. Some have highlighted the need to promote cultural and spiritual aspects of the populace while others stress the need for economic well-being, which stands as the foundation for all values. This text looks into the answers given by John Stuart Mill, Karl Marx, and Friedrich Engels. Mill concurs with Lock in vying for representational democracy; however, he is against the idea of natural rights (Pojman, 502). The struggle between Authority and Liberty has been ongoing for a long time particularly in the history of countries like Rome, Gre ece, and England. However, during such times, the contest was between the government and certain classes of subjects. Liberty meant protection against the dictatorship of political rulers. The rulers at the time obtained authority from conquest or inheritance. Therefore, most of them never held leadership at the pleasure of the citizens. Although their power was deemed necessary, it was regarded as highly dangerous. Some of the leaders would use authority as a strategic weapon against their adversaries or subjects (Pojman, 502). However, it reached a time when men stopped to believe that their governors should be independent. They deemed it fit that their leaders should be delegates or tenants revocable at their gratification. That way, they would have total security that the government authority will never take them for granted. Others still thought that there was a need to let their give responsibility to their leaders, where they can be removed if need be. This idea was common am ongst the last liberal European generation (Pojman, 504). However, in time, a democratic republic came into place as an elective and responsible government was ushered into place. The will of the people meant the will of the many. According to Mill, the only instance where power can be exercised in the right manner is when used on any civilized member of a community to prevent harm against others, against his will (Pojman, 505). However, this is not about minors in the society. Freedom should only be extended towards the pursuance of our own good in a specific way, so long as no other person gets hurt. A person who hurts others should be punished by law, in a situation where legal penalties cannot be safely applied. A person can also be compelled to do acts that would be of benefit to the rest of the society, for instance, to give evidence in a court of law, saving another human being’s life, or protect the defenseless. The society, in this case, will hold responsible the ind ividual should he fail to do the act. In this regard, a person can cause harm to others, not necessarily by doing wrong, but by refusing to do the right thing. Mill further argues that people should not have the right to coerce the government into doing something; such power in itself is illicit (Pojman, 507). It is even more noxious for a government to exert power as a result of public opinion. Basically, Mill promotes the idea that the principle of liberty is only justifiable by utilitarian reflections. 3. The Communist Answer according to Carl Max Karl Max played an instrumental role in the dawn of the Marxist movement. According to him, all cultural values, including all the laws and ideal, of a society are at all times the reflection of the rulers. History has always painted a picture of struggles between the classes (Pojman, 510). During the past periods of history, there has been an intricate arrangement of the society into different social orders, a diverse

Urbanization: An analysis

Urbanization: An analysis 2.1 Urbanization 2.1.1 Current discourse in urbanization concept Urbanization is growing in most part of the world in line with technological discovery and human civilization. The rapid urbanization began at England’s industrial capitalism (Clark, 1998) at the end of 18th century and it spread rapidly after the use of coal for the industry primary raw material and a better transportation system (Hall, 1994). In developing world, urbanization started in 1950 after the Second World War (Crenshaw, 1991) and it is growing everywhere now especially in Africa and Asia. United Nation’s report indicated that by 2050, most population will be concentrated in cities and towns of developing countries. By this year, if Africa and Asia continue their current rapid growths, 50 percent of the population will live in urban areas and in 2010 it is predicted that the urban population is higher than the rural one (figure 2.1) Figure 2.1 Urban and rural population of the world, 1950 2030 (Source: Junaidi, 2006) There are four existing definitions for urbanization concept that mostly be the attention of urban planners. First, urbanization is seen as a process in which there have occurred transferring ideas and practices from urban areas into surrounding hinterlands. Second, urbanization is viewed as the increase both in behavior and problems considered to be urban types of rural area. The third, urbanization is related with the process of population concentration in which it is found the increasing ratio of the urban population to the total population (Phren. K. P, 1962) and the fourth, urbanization is seen as the combination of densification or the increase of density of people and building unit and the outward spread of people and built areas (Forman, T. www.cambridge.org). However, all of these definitions are interelated that all the urban planner needs to consider them in urban planning process integratedly. There are many related concepts involved from these in defining urbanization definition. From economic point of view, urbanization tend to connect it with labor division; demography related with density and population size, sociologic regarding to the way of living, and the last is geography from characteristics of the built up environment (Crenshaw, 1991). However, most analysts agree that demography is the basic criterion in differentiate urban and rural area (Clark, 1998, White, 1994, UNECA, 1968) because the population growth, including population density change, are the most quantified way to see the growth of an area. The most common example is United Nation that also uses the population size to standardize the urban localities and city among the nations. Mostly literatures argue that the driving force for urbanization is economic reason (Clark, 1998; Crenshaw, 1991, Jeremias, 1988), but there is a difference in the background of which. In developed world, rapid urbanization occurred because of industrial revolution, capitalism, and the invention of technology and a better transportation system while in developing countries, urbanization tend to occur because of economic imperial. The developing countries’ cities were previously prepared for supporting the economic interest of the powerful regime to earn money, to expand and control foreign trade, to create new markets for products and to acquire raw materials and cheap labor (Crenshaw, 1991). Many specific reasons for the driving force of urbanization and the traditional literature categorized them as push and pull factors. The push factor occurred because of the pressure of poverty problem and environment degradation in rural area. The poverty occurs because of limited job opportunities, limited land for agriculture and other natural resources limitation. The pull factor is related to the attraction of urban area for a better life. It is often related to a wider job opportunity, higher economic growth, better services and modern facilities (Baiquni, 2004). From this pull and push factors, it could be seen the disparities between urban and rural area are the main reason making more and more population concentrated in urban area. 2.1.2 Urbanization determinant The proximate determinants of urban growth can be grouped into three categories: firstly, the total population; secondly, rapid economic growth; and the third, percentage of built up area and areal extend (White, 1994). Population size The more population size of an area, the more urbanized it will be and it is positively related to the growth of urbanization (Rogers, 1982). The increasing of population size is caused by both migration and mortality. Migration flows occur because of employment availability in nearby cities and towns, ethnic connections in particular cities, the roads development and the accessibility of transportation (Connell et al, 1976). Some researches stated that the economic imbalance resulting wage disparities in urban and rural is a major reason for high levels of rural-to-urban migration. The size of population in urban area will be in line with the needs of water for these urban dwellers. Economic growth It appears that rapid economic growth related to urbanization (Becker Morrison 1988, Preston, 1979) that the urbanization level of an area can be marks by its rapid economic growth. Mostly in urban area people do not work in agriculture sector as in rural area, but in service and manufacture. The manufacture developments in urban area have triggered the employment opportunities for rural people to come, and a higher wage offered by manufacture sectors compared to the agriculture ones results in a better economic condition and quality of life. The quality of life will also influence to the water consumption quantity and quality. Percentage of built up area The urban characteristic can be seen from the density of people and the increase of building units. The sign is can be seen from the reduction of green spaces or the changing from low to high-rise apartment buildings. Other sign of urbanization is the city grows by expanding outward. Cities may also urbanize by rolling over suburbs, and suburbs urbanize by rolling over farmland or natural land (Crenshaw, 1991). The changing of landsape by built up environment will be related with the number of recharge area and wastewater quantity that will influence the groundwater. 2.2. Groundwater system on earth Groundwater constitutes about 98 percent of water on earth and both its storage and flow is one of the key elements of natural water systems (Foster, S, 1998). This fact makes groundwater an essential element to human life and economic activities. The details about groundwater hydrology are beyond the scope of this discussion, but a general overview will be presented. Figure 2.2. Hydrology Cycle Source: http://www.climatescience.gov/Library/stratplan2003/final/graphics/images/SciStratFig5-1.jpg Groundwater is water located beneath the ground surface in soil pore spaces and including one component of the earth’s water cycle. The water cycle is called the hydrologic cycle and it involves the movement of water as rain, snow, water vapor, surface water and groundwater. The earth’s water is constantly circulating from the earth’s surface up into the atmosphere and back down again as precipitation. When rain falls, a part of it infiltrates the soil. A proportion of this water will be taken up by plants while some will infiltrate more deeply, accumulate above an impermeable bed, saturate the pore space of the ground, and finally form an underground reservoir. This underground reservoir is called an aquifer, a place from which significant quantities of water can be abstracted for human needs. An aquifers productivity to store and transmit water are not the same, it depends on the fundamental characteristic of its constitute. Some of which are granular sediment such as sand, cement sediment such as sandstone and limestone, rock and fracture rock. The ground above an aquifer through is called the vadose zone; it is where the excess rainfall passed vertically. The level to which the ground is fully saturated is known as the water table. The nature, the occurrence of groundwater and the movement of water trough groundwater system is shown in the figure 2.2. 2.3 Urbanization and groundwater resources 2.3.1 Current Discourse Urbanization has been recognized as a trigger of social and environmental problems (Dogan Kasarda 1988, Timberlake 1985). The rapid expansion in groundwater exploitation of many industrialized nations occurred during 1950–1975 while in in most parts of the developing world it occurred during 1970–1990 (Zektser Margat 2003). The groundwater is estimated to provide at least globally 50% of current potable water supplies; 40% of the demand from industries, and 20% for water use in irrigated agriculture (Foster, 1998). These proportions vary widely from country to country and within countries depending on human activities on it. The groundwater is generally the main water resource to be tapped for urban dweller needs if a city has productive aquifers (Minciardi, 2007; Somma. 1997; Hiscock, 2002). This is because the groundwater has an excellent natural quality with significant savings in treatment costs compared to other surface water source. Other reason is because groundwater is a more secure source of water supply during long dry periods compared to the surface water resources (Clark, 1998, Ohgaki, 2007). Groundwater is also a suitable for public supply and independent private use, especially during the early stages of development (Foster, 1998). Two common methods for urban aquifer exploitation are by hand-dug wells and drilled boreholes (Foster, 1998). Hand-dug wells are usually less than 20 meters depth with diameters of 1 meter or more. In this method, the water is usually abstracted manually or by small pumps. The water supply boreholes are mechanically drilled, usually having smaller diameter than hand-dug wells, but much deeper ranging from 20 to 200 meters or more in depth. These two methods if developed in uncontrolled manner will cause groundwater depletion as it has occurred in many urban cities over the world (Ohgaki, 2007; Minciardi, 2006; Foster.S.S.D, 2001). 2.3.2 Urbanization impact to groundwater resources It has been identified that urbanization results in aquifer depletion, saline intrusion, and land subsidence, changing patterns and rates of aquifer recharge and affecting the quality and quantity of groundwater (Foster, 1998, White, 1994, Ohgaki, 2007, Minciardi, 2006). In this discussion the overall focus will be on the depletion of groundwater quantity related urbanization. Figure 2.2. Urban development and its impact to water resources Source: (Foster, 1998) From the figure above, it could be seen the urban development and its impact on the changing of urban groundwater. In the beginning, all cities evolve from small settlements; formal or informal. In this stage, the city dwellers can abstract groundwater using shallow well and boreholes as the groundwater is still abundant. As the infrastructure for wastewater either has not been adequate yet or less than the population needs, the wastewater starts discharging to the ground and starts to pollute the groundwater supply. When the town becomes city, the need of water supply is getting higher resulting from rapid urban population growth in contrast with the decline of groundwater supply. As the result, the well is deepened and there has been occurrence of land subsidence because of more urban dwellers do this deepening. The wastewater is still continuing to pollute the groundwater. The city then expands in line with the urbanization trend resulting to more water needed, more contaminant enters groundwater system and water table rises beneath the city. The urban dwellers start abandons their groundwater resources while the groundwater exploitation of hinterlands area as the alternate sources are getting higher. Because of the storage capacities of most aquifers are large, there is often a major time lag before the problems of groundwater depletion, water table rise and groundwater pollution becomes fully apparent (Foster, 1998). Further, there is increasing water supply scarcity with higher marginal costs for urban water supply. At the end, the traditional use groundwater that is low cost, minimally treated, and abundant for public water supply in urban areas is being threatened. Groundwater depletion The abstraction of groundwater has proved to be the cause of a qualitative decline in water levels. If abstraction is limited, the water level will be stabile at a new equilibrium. However, if occurs either a heavy or and concentrated groundwater withdrawal until it exceeds the local recharge, the water level may continue to decline over many years. As the result, there will be spreading of depress water level, land subsidence, water quality deterioration, sea water intrusion, up-coning and induced leakage of polluted water from the surface (Foster, 1998; Wangsaatmaja, 2006; Braadbaart, 1997) Mostly the problems and causes of aquifer depletion and contamination are clear while immediate solutions are not. General solutions involve some combination of increased recharge rate, reduced consumption rate, efficiency gains, and reduced or eliminated contaminant sources (Vo, 2007, Venkatesh Dutta, Foster.S.S.D, 2001). For example, reducing the velocity of runoff and providing time for recharge could enhance groundwater supplies significantly and at the same time reduce land-based sources of pollution to receiving waters. Land subsidence Land subsidence occurs for a variety reasons, but natural and manmade groundwater abstraction is one of the most contributor to this condition. The remedying efforts of the land subsidence impact involve a high economic cost (Foster, 1998). It is because differential subsidence damages roads, buildings, and other surface structures and it can seriously disrupt underground services such as water mains and water pipelines, sewers, cable conduits, tunnels, and subsurface tanks. In cities located on flat topography, subsidence can disrupt the drainage pattern of rivers and canals and can increase the risk of flooding. The land subsidence effects can be more serious in coastal areas because it can increase the risk of inundation (Hiscock, 2002). Saline intrusion The uncontrolled aquifer exploitation will impact on saline intrusion and it is usually occurs in coastal area. When the groundwater levels fall, the water flow direction change occurs. For thin and alluvial aquifers, this condition results in the formation of wedge shaped pattern and but in the thicker ones, salinity inversions often occur with intrusion of sea water in near-surface aquifer and fresh groundwater in deeper area. Once salinity has diffused into the pore water, its elution will take decades or centuries. Induced pollution Uncontrolled exploitation has consequences to contaminate the deeper aquifer. This induced pollution is caused by inadequate well construction, vertical pumping-induced, and sewage. Some rapidly developing cities have provided mains sewerage and generate large volumes of wastewater but this wastewater is normally discharged untreated or with minimal treatment to surface watercourses. It especially occurs in more arid climates (Anderson, 1987). 2.4 Urbanization Impact on groundwater management policy Although groundwater is the source of drinking water for most people, it is often ignored and taken for granted in urban planning program. The problem was expressed this way by the US Water Council in 1980: â€Å"The role of groundwater in water supply often has been slightenend in the past, one reason being believed that groundwater couldnot be adeqately evaluated in terms of avalibility, chemical quality, economics, or injuctive supply with surface water resources. However, substantial progress in groundwater analitical capability in recent years has made the resources more amanable to rational planning and management operation† (US Water Council in Grigg, 1996) Urban groundwater problems evolve over many years or decades as the result of slow the respond to most groundwater problem. The groundwater depletion and pollution problem are usually solved in incremental way by abandoning the shallow wells and replacing them with deeper boreholes to the aquifer (Grigg, 1996). However, this approach may only provide a temporary solution and if the urban planners continue this method, the groundwater supply will be in more stress condition. Therefore, the more comprehensive and sustainable groundwater planning and management approaches are needed to be developed (Tellman). 2.4.1 Groundwater Management Many literatures define groundwater management differently. Some emphasizes on the technical aspect such as engineering and hydrology, some are the process of managing and some others are the combination of them. However, the common similarity is on their objective that groundwater management is prepared to ensure that groundwater resources are managed in a fair, equitable and sustainable manner (Hiscock, 2002; Ohgaki, 2007; Minciardi, 2006;Venkatesh Dutta). Groundwater management can be defined as a number of integrated actions related to both natural and managed of groundwater pumping and recharge to achieve the long-term sustainability. California government in 2003 DWR Bulletin 118 2003 defines groundwater management as a set of activities including the planned and coordinated monitoring, operation, and administration of a groundwater basin or portion of a groundwater basin with the goal for long term sustainability of the resource. As the result, the groundwater management involves a number of engineering disciplines including survey and monitoring, geological interpretation, hydrological assessments, hydrogeological modeling, chemical and geochemical assessments and optimization. Groundwater management also deals with a complex interaction between human society needs and physical environment and it presents a difficult problem of policy design (Foster.S.S.D, 2001; Somma, 1997). For example, aquifers are exploited by human decisions for sustaining their lives and overexploitation cannot always be defined in technical terms, but as a failure to design and implement adequate institutional arrangements to manage people who exploit the groundwater resource. Common pool resources have been typically utilized in an open-access framework because of the characteristics of groundwater resources (Somma, 1997). When no one owns the resources, the users do not have any obligation to conserve for the future, and as the result, self-interest of individual users leads them to overexploitation. Groundwater management is a debated issue with very few examples of effective action on groundwater resources. However there some approaches that several studies concluded them as a successful groundwater methods, for example, sustainable groundwater development and management in the overexploited regions is treated by combining artificial recharge to groundwater and rainwater harvesting; management of salinity ingress in coastal aquifers; conjunctive use of surface water and groundwater; water conservation by increasing water-use efficiency; regulation of groundwater development.. Further, there also innovative methods of recharging the groundwater and storing water in floodplain aquifers along the river banks to enhance the ultimate irrigation potential from groundwater. The following four steps are essential for most groundwater management cases. Firstly, there must be regular and accurate assessment of actual groundwater use in both rural and urban areas to correlate with recharge and extraction. Secondly, expansion should be strictly monitored. Thirdly, separation of feeders for domestic and agricultural power and the fourth, ways must be explored to empower and entrust the communities to manage the groundwater uses. Development of groundwater management is usually begun by an assessment of groundwater problems and management issues, a compilation of groundwater management tools, an identification of action to address issues and problems, selection of the management plan and a discussion of implementation aspects of the plan. Mostly, the suitable groundwater management approaches are identified at the local water agency level and directly resolved at the local level. However, the State also has role in providing technical and financial assistance to local agencies for their groundwater management efforts. The Department publishes a regulatory framework for groundwater management to ensure that the groundwater resources are maintained and used in an orderly, equitable, and sustainable manner. If groundwater management is obeyed and the problem cannot be directly resolved at the local agency level, there is usually an additional actions such as enactment by local governments or decisions by the cou rts. 2.4.2 Sustainable groundwater management Groundwater is an important source of clean drinking water in many areas because of its characteristics, but mostly a sustainable management has not yet been established for this resource. Natural water bodies have become the place for storing human activities products, such as wastewater and other industrial pollution, causing little natural water storage capacity left. The sustainable groundwater management needs to involve a larger management system including the development of alternative surface water supplies, reallocation among economic uses of water, and regulatory limits on abstraction. Like other water resources management and other environment issues, all elements of active aquifer management must involve stakeholder participation and whole basin analysis. It means that sustainable groundwater management should take place on various levels, starting from the localized borehole owner and user to the regional aquifer, basin and catchment area. At the end, the groundwater development will much depend on management principles applied by Local authorities, Government and Inter Governmental development planning and management strategies. By taking appropriate measure, sustainable groundwater management development can be built. In urban planning practice these measures tend to reduce sewer overflows, improve the quality of treatment plant effluent and prevent falling water tables in areas around towns, cities, and the hinterlands. 2.4.3 Major approaches in sustainable groundwater management The literature generally literatures found that the approaches for sustainable groundwater management are divided into spatial and a-spatial approaches as below. The most common similarity in these approaches is that one method cannot stand alone but must be integrated and connected with other disciplines and other sectors. Integrating sustainable groundwater in spatial planning and management a.1) The use of `Hydrological Design Principles This approach involves zoning related to the catchment planning approach, the location approach, and buffering approach. The `Hydrological Design Principles as a basis for making spatial planning decisions or design of land use patterns is the most common approaches for groundwater management. The Catchment Planning Approach objectives are both to adjust land uses or activities with environmental requirements in the catchment area or drainage basin and to prevent peak discharges. This is implemented by allocating land use profiles to each catchment area and by taking account to maintain or increase the catchment areas’ water storage capacity. The attention to be paid is to both water quality and quantity aspects, which are to be managed with the most important goal for achieving an ecological balance with the land use activities. The Location Approach’s aims are to order the various land uses and activities within each catchment area so that the affect occurs is as little as possible to each of them. In this approach, the land uses that have greater demands on water quality are located upstream of more polluting ones, while the more vulnerable uses is located in areas of groundwater seepages. The clean land use activities are placed in the infiltration areas. The Buffering Approach is used to give chance the land uses with incompatible environmental requirements to co-exist. A well-known example at the local level is the hydrological buffering of natural sites from surrounding agricultural land. This can be achieved through appropriate design and management measures that can be implement in a relatively easy and quick manner. a.2) Integrating land use activities, groundwater systems and the environment The approaches are by water storage, habitat creation and natural water treatment combined with new urban development. In many places where the abstraction of drinking water causes damage to nature, water may be abstracted elsewhere instead, for example is in the hinterlands of that area. In some cases, groundwater abstraction should be stopped regarding to riverbank filtration. Water from the river can be pumped into the ground under the banks and later abstracted when it has been sufficiently filtered by passing through the sand and clay in the sub-soil. Raising storage capacity in the river basin through habitat creation, landscaping and establishing outdoor recreation areas are also other approaches for this method. The groundwater system had double function for human life. a.3) Ensuring enough room for water: Catch water where it falls It is mostly done in the areas around the main rivers or flood prone area. It can be in line with habitat protection because the raising the water storage capacity by lowering the ground level of the river or moving back the dikes back offer opportunities for nature development. The widening ditches and raising the drainage level can increase the water storage capacity. As the result, more room for water and the rainwater can be infiltrated into the soil instead of being drained away as quickly as possible to the sewer. An advantageous effect of giving water more room is the greater opportunity it presents to make use of natural filtration and water purification processes. a.4) Controlling subsurface contaminants load and ensuring sufficient clean water Water pollution problems can be partially minimized or controlled by delineating source protection zones around major groundwater catchment areas. On the other hand, there are some related approaches such as firstly; appropriate planning provisions or mitigation measures to reduce contaminants load in particular areas, especially where aquifer is highly vulnerable. Secondly, to moderate the subsurface contamination to acceptable levels by considering the vulnerability of local aquifers to pollution, land use planning to reduce potential pollution sources. Thirdly by selecting controls over effluent discharges and other existing pollution sources and the fourth is by planning waste water treatment or landfill disposal sites regarding to groundwater interests and impacts. Integrating sustainable groundwater in a-spatial planning and management b.1) Institutional management To improve groundwater management, a strong institutional framework is prerequisite. Regarding to groundwater characteristics, an ideal institutional framework should to include legislation to provide clear definition of water use rights that is separate from land ownership. It could be implemented through granting of licenses and tax for groundwater exploitation in a specified manner. Other approach is by regulating and supervising the discharge of liquid effluents to the ground, the land disposal of solid-wastes, and other potentially polluting activities with a need legal consent or planning approval. Some literatures also presented about the behavior change and prospectus in groundwater that is believed can be last longer than the technical approaches. b.2) Demand side management Groundwater management not only requires adequate assessment of available resources and hydrogeology by understanding of interconnection between surface and groundwater system, but also actions required for proper resource allocation and prevention of the adverse effects of uncontrolled development of ground water resources for short and long term. One of the important strategies for this is a-spatial sustainable management of groundwater by regulating the groundwater development in critical areas using demand side approach. Management of demand means managing efficiency of water use, interaction among economic activities that is adjusted with water availability. In demand side management, socio economic dimension plays an important role that it also involves the managing the users of water and land. It is because the regulatory interventions in demand side management such as water rights and permits and economic tools of water pricing will not be successful if the different user groups are not fully involved. As the result, for achieving effective management of groundwater resources, there is a need to create awareness among the different water user groups and workout area specific plans for sustainable development. From among these two characteristics, it can be concluded that there are two emerging broad types of management approaches for groundwater. Firstly, approaches including tools such as power pricing, subsidies for efficient technologies, economic policies discouraging water intensive crops, etc. Secondly, approaches dealing with specific aquifers on the basis of command and control management through a resource regulator. Whichever approach is adopted, the development and management of these resources must be based on an adequate knowledge of a clear comprehensive situation of groundwater aquifer system and its replenishment. Contents CHAPTER II 1 URBANIZATION AND GROUNDWATER PLANNING 1 2.1 Urbanization 1 2.1.1 Current discourse in urbanization concept 1 2.1.2 Urbanization determinant 3 a) Population size 3b) Economic growth 3c) Percentage of built up area 42.2. Groundwater system on earth 4 2.3 Urbanization and groundwater resources 5 2.3.1 Current Discourse 52.3.2 Urbanization impact to groundwater resources 6a) Groundwater depletion 8b) Land subsidence 9c) Saline intrusion 9d) Induced pollution 92.4 Urbanization Impact on groundwater management policy 9 2.4.1 Groundwater Management 102.4.2 Sustainable groundwater management 122.4.3 Major approaches in sustainable groundwater management 12a) Integrating sustainable groundwater in spatial planning and management 13a.1) The use of `Hydrological Design Principles 13a.2) Integrating land use activities, groundwater systems and the environment 13a.3) Ensuring enough room for water: Catch water where it falls 14a.4) Controlling subsurface contaminants load and ensuring sufficient clean water 14b) Integrating sustainable groundwater in a-spatial planning and management 15b.1) Institutional management 15b.2) Demand side management 15

Medical Ethics :: essays research papers

Quaestiones Disputate #3) Whether it is ethical to keep a person alive if their quality of life is not good and will not improve. In such a case, what is the responsibility of the medical profession?   Ã‚  Ã‚  Ã‚  Ã‚  The following argument will be made toward the negative, suggesting that it is intrinsically unethical to keep a person alive under certain circumstances The first issue to address is the sub-components of the Quaestione in order to better set the argument in motion as a proof. The Quaestione can be divided up into the following components [whether it is ethical to keep a person alive] , [if their quality of life is not good] , [and will not improve]. , [In such a case, what is the responsibility] , [of the medical profession].   Ã‚  Ã‚  Ã‚  Ã‚  The first component is, in a general sense, unarguable. Standing alone, the statement of keeping someone alive bears a right to which every human is morally obliged to uphold. They key here is standing alone....Of course society’s code of conduct says that we must preserve life, but this can only be true to a sense until the next issue is incorporated - what if their life is not good?   Ã‚  Ã‚  Ã‚  Ã‚  What exactly is not good? If we take it from an Aristotelean point of view, we can see that Aristotle claimed that happiness or good living - being happy, healthy, prosperous, and flourishing - is the goal of human life and the basis of all ethical behavior. This eudaimonia that he begins to describe is an end, in a sense that that goal has been reached. If one can no longer reach this ultimate goal or end or is rendered unable to physically or mentally move oneself in that direction (after all, someone else can’t live your life for you to move you to happiness) their life is considered not good. A life rendered not good combined with our ethical obligation to keep someone alive, probably still not enough to grant the individual the ultimate end.   Ã‚  Ã‚  Ã‚  Ã‚  Now if you listen closely, this is where the turning point begins. Being a teleologist, Aristotle claims that every action is good only in so far that they achieve some good end. If life is not good, and we reach stage three where it will not improve, where is the action of keeping the individual alive reaching a good end. The life is not good, nor will it ever be good - so what is the good end that would result that would warrant this action to be a good action.