A Day as a Physical Therapy Volunteer :: Community Service, Service Learning

As usual, John is late. Because the other two Physical Therapists (PTs) are busy on their rounds, I just wait, sitting on the therapy tables reading the assorted pamphlets that are available to the patients. Every part of the body is represented in these books on the shelf. A slight humming sound comes from the air conditioner. The freshly waxed tile floor reflects the light that shines from the ceiling tract lights. Since I am a volunteer, the lowest on the totem pole of health care, I have no specific duties. Mainly, I observe the work of the PTs. I also assist in cleaning the immaculate therapy room. As I wash down the tables with ammonia, trying not to inhale too many fumes, a Dr. Riddel is paged over the hospital intercom. Then someone else is paged, "Thomas Lykins to front desk. Thomas Lykins to front desk." Front desk actually means office, and usually social workers are paged to clear up some problem. I also stock the linen closet. Every patient who lies on the big brown therapy table has to be on a sheet with at least 2 or 3 towels nearby. The towels feel rough and course from years and years of reuse. Everything gets the ammonia treatment, including the silver parallel bars, the whirlpool and the giant rubber gym balls that are used with patients who have bad backs. Suddenly, the door swings open and all of the sounds from the nearby emergency room flood into the room. John has returned from his lunch break. He brings a patient to the gym to work on the bars. Hunched in her wheelchair, staring at the ground, her gray hair a mess, she shakes slightly. I think, "Can’t the PTs feel the coldness in this room? Maybe their white lab coats keep them warm." John says, "Paige, this is Mrs. Meyer. She is going to walk the bars today." He asks, "Aren’t you, Mrs. Meyer?" All that Mrs. Meyer can do is mumble "Yes, I hope." Mrs. Meyer had a stroke, her second. John tells me privately so that she can’t hear. She seems to be in a state of confusion about where she is and who we are. John wheels Mrs. Meyer to the silver parallel bars and helps her stand. Slowly talking very quietly, he assures her that he will not let her fall, if she can’t balance herself. I stand behind her, as instructed by John.

Is Routine Circumcision of Infants Ethical?

History of Circumcision: Reviewing the history of circumcision and the many misguided reasons for its practice will help form an understanding of the multifaceted issues concerning routine infant circumcision. Some of the earliest evidence of male circumcision comes from Egypt around the year 3000 BC. However, researchers studying this practice do not understand or agree on its purpose. Some researches believe that circumcision was a form of branding for slaves while others thought it to be from the priestly class as a form of religious ritual. But when is more pertinent to this argument is that the early Greeks and Romans outlawed male circumcision believing it to be a barbaric form of mutilation of male genitalia. The first documented purpose for circumcision is in the Old Testament Scriptures (Gen 17:10) concerning the covenant between Abraham and God, representative of the relationship between Israel and Yahweh. According to the governing doctrinal resource for Catholics worldwide, the Catechism of the Catholic Church, the explanation for Old Testament circumcision is in section 1150. 1150 – †¦Among these liturgical signs from the Old Covenant are circumcision, anointing and consecration of kings and priests, laying on of hands, sacrifices, and above all the Passover. The Church sees in these signs a prefiguring of the sacraments of the New Covenant. † The circumcision of Jesus in the New Testament explains that when Jesus came, as the fulfillment of prophecy that the new covenant manifested through th e innocent blood of Jesus replaces once and for all the old covenant through Father Abraham. There is no longer a need for animal sacrifices and the early Christian community determined that baptism was to be the new sign of the covenant. â€Å"527- Jesus' circumcision, on the eighth day after his birth, is the sign of his incorporation into Abraham's descendants, into the people of the covenant. It is the sign of his submission to the Law and his deputation to Israel's worship, in which he will participate throughout his life. This sign prefigures that â€Å"circumcision of Christ† which is Baptism. Routine infant circumcision in the United States became prevalent in the Victorian age (1840) and reached its height during the Cold War (1940) when technology, hospitals, and modern medicine sought to institutionalize the birthing process. Including more than 90% of boys, infant circumcisions became so routine that doctors performed the procedure without actually receiving consent from the parents. Parents not desiring the process for their sons were considered negligen t. Given the history and the misguided reasons for practicing routine circumcision, â€Å"Why would a parent authorize, a doctor perform, or an insurance company pay for, the routine circumcision of infants? † A. Health Reasons- certainly it would be ethical to surgically remove the penis foreskin of a male infant if in some way it presented a health risk; there is no real argument here. B. Tradition-for generations, infants have undergone various procedures under the reasoning of â€Å"tradition. From binding feet in Japan (which has been banned) to piercing ears, and stretching necks, tradition plays a large part in the decision for circumcision. Many men, who like their own fathers were circumcised as infants, think that their child in turn might as well be circumcised too. However, is there any real thinking going on here at all? I argue that just because everyone else jumps off a bridge, is that any reason for you to jump off as well. Religious Beliefs- I would have to say yes, it is ethical to have a child circumcised if you are following a true religious belief. The parent who has legal authority over their child may choose (and in fact is morally obligated to choose) to do what they believe is in the best interest of the child. Therefore, for the Jews who believe that the outward sign of circumcision establishes their child in a covenantal relationship with God; they are well within their ethical right and responsibility to have their sons circumcised. Freedom of religion is one of the building blocks of our free nation. Circumcision mentality: Today thanks in part to our mass media; modern society is ruled by prevailing mentalities. These pervasive mindsets allure us to what appears to be the benefits of circumcision, while completely obscuring any possible negative ramifications. The mentality is permeated into societal norms, which are almost impossible to resist, and are most difficult to correct. An accepted societal mentality is further driven by force of habit. Among other things, we live in a society that assumes that a male infant in the United States is routinely circumcised. Seldom are discussions of the pros and cons of the procedure brought to the attention of the parent, unless the parent specifically requests it. Even then, the doctor may say, â€Å"It is not medically necessary but if the boys father has been circumcised, then you should probably have your son circumcised as well†Ã¢â‚¬ ¦or â€Å"you wouldn’t want him to look different than his friends when he becomes a high school student in the locker room. † Medical Ethics: When looking into medical ethics, the Oath of Hippocrates standard for medical professionals since 400 BCE shed some additional light onto the situation. From the Oath: â€Å"I do solemnly swear by whatever I hold most sacred, that I will be loyal to the profession of medicine†¦that I will exercise my art, solely for the cure of my patients and the prevention of disease†¦Ã¢â‚¬  Therefore, considering the Hippocrates oath, a routine circumcision of an infant male does not fall into the category of â€Å"†¦curing a patient, and the preventing of disease†¦Ã¢â‚¬  Why then would doctors perform such an unnecessary procedure Catholic Theological Ethics: As a student of Theology, from a Roman Catholic perspective I have yet to hear a discussion concerning the morality of circumcision. However after researching the Catechism of the Catholic Church (CCC) under the subtitle â€Å"Mutilation of body parts† section 2297 reads, â€Å"Except when performed for strictly therapeutic medical reasons, directly intended amputations, mutilations, and sterilizations performed on innocent persons are against the moral law. † VI. Personal Ethics: Each parent possesses the God given right to make certain decisions on behalf of their young children who cannot make these decisions themselves. A good example is immunizations; no infant has the capability to make this decision, so the parent, in the child’s best interest makes the decision to have the child immunized. I am a mother of four sons, born in the years 1983, 1985, 1991 and 1992. Although the father of the boys was circumcised however, none of our boys is circumcised. To this day, none of them has ever had trouble of any kind, nor has it been an issue in the locker room. The decision to leave the boys as they were born, uncircumcised, was based on the fact that it was not a medical necessity, that anesthetic was not used (they had just been traumatized in birth), and that there was a possibility of complications from the procedure. Parents need to take a more proactive stance in researching the pros and cons of the procedure, and should spend at least as much time and energy on this decision as they do in picking out a new car! VII. Objective – If the objective of the National Organization of Circumcision of Infants Resource Center is to reduce the number of routine circumcisions performed, I believe that to pursue this objective through legal channels alone would be fruitless. Big government has more than enough authority in dictating to families what they can and cannot do for their children. Your best bet would be to lobby the insurance companies. Perhaps you could demand coverage for an elective surgical procedure such as having your breasts enlarged and when they tell you no that it is just a cosmetic or optional procedure, sue them for discriminatory practices. The last thing an insurance company wants is a class action lawsuit. It would be simple for them to simply take routine infant circumcisions off their list of covered procedures. In addition, a non-covered expense for an unnecessary procedure may prompt parents to give this issue closer consideration. D. Moral Law: Next, one must consider which law is the governing authority in your life. The Moral Law operates under a set of religious beliefs. Found within the moral law are the Jewish Law, and the Christian Law (for the sake of brevity we will not mention other religious groups here). The Jewish Law of Circumcision establishes a covenant between God and Abraham (Gen 17:10), representative of Yahweh and Israel. The Christian Law comes into effect with the birth of Jesus. Jesus becomes the new sign of the covenant, with the Baptism of infants as the effective cause. Concerning Civil Law under which all persons are bound; it has little criteria for establishing ethical arguments. One may ask questions of the law: if allowing an un-anaesthetized circumcision is lawful, and what recourse would a child have if the procedure causes permanent damage to the male organ but these are considered civil, not ethical. Additionally, why would an insurance company pay for such an unnecessary procedure (when so many don’t pay for many true necessities)? Perhaps it should be regarded as â€Å"elective surgery† and therefore it would be a charge paid for entirely by the parent requesting the procedure, not as an â€Å"ordinary and customary† procedure paid for by the insurance companies. However, the Hebrew people alone practiced the circumcision of infants on the 8th day after birth. The child’s father, using a flint knife, preformed circumcision

Workability For Concrete Specimens Finance Essay - Free Essay Example

Sample details Pages: 5 Words: 1354 Downloads: 3 Date added: 2017/06/26 Category Finance Essay Type Research paper Did you like this example? The results of compressive strength for concrete reinforced by adding 2.5 of wastes cigarette butts (W.C.B) by volume are present in this chapter. In this study, three type of mixing concrete mixes will be designed for constant grade 30 but using different percentage of water to cement ratio (w/c). The w/c is 0.55, 0.60 and 0.65 were conducted. Don’t waste time! Our writers will create an original "Workability For Concrete Specimens Finance Essay" essay for you Create order In this present study, there are attempt in utilize of cigarette butts in fired clay bricks conducted by Aeslina et al., 2010. Four variables of mixing are using different percentages of cigarette butts which are 0%, 2.5%, 5.0% and 10.0% by weight. The compressive strength test shows that the strength decreases with the increasing proportion of cigarette butts. The compressive strength test determines the maximum load that the specimen could sustained over cross sectional area at ages 134 days. Workability for Concrete Specimens Workability test include slump test, vebe test and compacting factor test. In this study, each of the tests was conducted to test three types of mix which have w/c 0.55, w/c 0.60 and w/c 0.65 and a control mix of w/c 0.55. The results of all the tests were tabulated in Table 4.1, Table 4.2 and Table 4.3 respectively. Slump Test for Concrete Specimens Table 4.1 shows the result of slump test for three types of different w/c specimens with constant amount of W.C.B and a control mix specimen that without the W.C.B contents. Control mix specimen gave a 70mm of slump which is the lowest slump value compare to the other specimens that mixed with W.C.B. For specimens with w/c 0.55, w/c 0.60 and w/c 0.65, their slump values were 85mm, 120mm and 150mm respectively. It was shown that the w/c of 0.65 has the highest slump and highest workability in this study. Figure 4.1 illustrated the result of slump test for different mix specimens. Table 4.1: Results of Slump Test for Different Mix Specimens Water to Cement Ratio (w/c) Slump (mm) Control Mix 70 0.55 85 0.60 120 0.65 150 Figure 4.1: Results of Slump Test for Different Mix Specimens Vebe Test for Concrete Specimens Table 4.2 shows the results of Vebe test for three types of different w/c specimens with constant amount of W.C.B and a control mix specimen without the W.C.B content. There was 3.20seconds of Vebe obtained for the control mix specimen, which is the highest among other specimens. For w/c 0.55, there is 3.05s while for w/c 0.60, 2.70s was obtained. Specimen with w/c of 0.65 has the lowest Vebe which has only 2.25s which has the highest workability. Figure 4.2 illustrated the result of Vebe test for different mix specimens. Table 4.2: Results of Vebe Test for Different Mix Specimens Water to Cement Ratio (w/c) Vebe (s) Control Mix 3.20 0.55 3.05 0.60 2.70 0.65 2.25 Figure 4.2: Results of Vebe Test for Different Mix Specimens Compacting Factor Test for Concrete Specimens Table 4.3 shows the results of compacting factor for three types of different w/c specimens with constant amount of W.C.B and a control mix specimen without the W.C.B content. It was clearly shown that control mix has low compacting factor due to the large percentage of deviation 0.957% that is from 16.3kg to 15.6kg. Specimen with w/c 0.65 gave the lowest deviation 0.994% which is from 16.3kg to 16.2kg, hence it has highest compacting factor. For specimens of w/c 0.55 and w/c 0.60, their deviations were 0.982% and 0.988% respectively. Figure 4.3 illustrated the result of compacting factor test for different mix specimens. Table 4.3: Results of Compacting Factor for Different Mix Specimens Water to Cement Ratio (w/c) Weight (kg) Percent of Compacting% Before After Control Mix 16.3 15.6 0.957 0.55 16.7 16.4 0.982 0.60 16.6 16.4 0.988 0.65 16.3 16.2 0.994 Figure 4.3: Results of Compacting Factor for Different Mix Spe cimens Compressive Strength for Concrete Specimens The compressive strength test is carried out to determine the strength of the concrete cube with additional of waste cigarette butts (W.C.B) at ages 7, 14 and 28 days. The compressive strength was calculated using Equation 3.2 as mentioned in chapter 3. Three different mix of water cement ratio (w/c) were considered namely as Mix A (w/c 0.55), Mix B (w/c 0.60) and Mix C (w/c 0.65). A control mix with w/c 0.55 and no cigarette butt content was tested in order to compare the results from the specimens with Mix (A, B and C). Effect of Water to Cement Ratio on Compressive Strength for Concrete Due to Different Mix at Ages 7 days Table 4.4 shows the result of compressive strength for different w/c mix with addition of 2.5% of waste cigarette butts (W.C.B) by volume at ages of 7 days. Figure 4.4 illustrated that the compressive strength of concrete due to different mix at age 7 days. The results show that the compressive strength was decreasing with the increasing of water cement ratio (w/c). Compressive strength of 14.53MPa was obtained for w/c 0.55, 14.51MPa for w/c 0.60 and 10.91MPa for w/c 0.65 while the control mix achieved 19.00MPa. It is noticed that the compressive strength for w/c 0.55 is 14.53MPa which is decreases by 23.5% compared to the compressive strength of control mix. For w/c 0.60, it decreases by 23.6% while for w/c 0.65, it decreases by 42.6%. Table 4.4: Compressive Strength for Concrete Due to Different Mix at Ages 7 days Water to Cement Ratio (w/c) Compressive Strength (MPa) 1 2 3 Average Control Mix 17.99 19.49 19.52 19.00 0.55 14.31 15.01 14.17 14.53 0.60 14.38 14.65 14.51 14.51 0.65 10.08 11.32 11.34 10.91 Figure 4.4: Compressive Strength for Concrete Due to Different Mix at Ages 7 days Effect of Water to Cement Ratio on Compressive Strength for Concrete Due to Different Mix at Ages 14 days Table 4.5 shows the result of compressive strength for different w/c mix with addition of 2.5% of waste cigarette butts (W.C.B) by volume at ages of 14 days. Figure 4.5 illustrated that the compressive strength of concrete due to different mix at age 14 days. The results show that the compressive strength was decreasing with the increasing of water cement ratio (w/c). Compressive strength of 17.55MPa was obtained for w/c 0.55, 17.16MPa for w/c 0.60 and 11.81MPa for w/c 0.65 while the control mix achieved 20.37MPa. It is noticed that the compressive strength for w/c 0.55 is 17.55MPa which is decreases by 13.8% compared to the compressive strength of control mix. For w/c 0.60, it decreases by 15.8% while for w/c 0.65, it decreases by 42.0%. Table 4.5: Compressive Strength for Concrete Due to Different Mix at Ages 14 days Water to Cement Ratio (w/c) Compressive Strength (MPa) 1 2 3 Average Control Mix 21.22 20.38 19.52 20.37 0.55 19.61 16.5 5 16.50 17.55 0.60 19.76 15.82 15.89 17.16 0.65 11.26 12.35 11.82 11.81 Figure 4.5: Compressive Strength for Concrete Due to Different Mix at Ages 14 days Effect of Water to Cement Ratio on Compressive Strength for Concrete Due to Different Mix at Ages 28 days Table 4.6 shows the result of compressive strength for different w/c mix with addition of 2.5% of waste cigarette butts (W.C.B) by volume at ages of 28 days. Figure 4.6 illustrated that the compressive strength of concrete due to different mix at age 28 days. The results show that the compressive strength was decreasing with the increasing of water cement ratio (w/c). Compressive strength of 19.11MPa was obtained for w/c 0.55, 18.07MPa for w/c 0.60 and 15.47MPa for w/c 0.65 while the control mix achieved 22.42MPa. It is noticed that the compressive strength for w/c 0.55 is 17.55MPa which is decreases by 14.7% compared to the compressive strength of control mix. For w/c 0.60, it decreases by 19.4% while for w/c 0.65, it decreases by 31.0%. Table 4.6: Compressive Strength for Concrete Due to Different Mix at Ages 28 days Water to Cement Ratio (w/c) Compressive Strength (MPa) 1 2 3 Average Control Mix 23.00 23.60 20.67 22.42 0.55 19.19 19.1 7 18.98 19.11 0.60 17.49 17.52 19.19 18.07 0.65 15.42 15.47 15.51 15.47 Figure 4.6: Compressive Strength for Concrete Due to Different Mix at Ages 28 days t-Test Analysis for Compressive Strength at Ages 28 days The summary of t-test analysis for control mix is presented in Table 4.7. Since the null hypothesis stated that there was no statistically significant different between control mix and w/c 0.55, the analysis result failed to reject the null hypothesis as indicated by: tstat lt; tcrit (3.69lt;4.30) and P gt; Icirc;Â ± (0.07gt;0.05). Therefore it can be concluded, at 95% confidence level, there was no significant difference between control mix and the specimen which w/c is 0.55 as the alternative source material. Table 4.7: t-Test: Two-Sample Assuming Unequal Variances W/C C/M 0.55 Mean 22.42333 19.11333 Variance 2.395633 0.013433 Observations 3 3 Hypothesized Mean Difference 0 df 2 t Stat 3.693722 P(Tlt;=t) one-tail 0.033055 t Critical one-tail 2.919986 P(Tlt;=t) two-tail 0.066109 t Critical two-tail 4.302653 Acirc;