A Midwifery Community Profile Health And Social Care Essay

A Midwifery Community Profile Health And Social Care Essay This community profile is based on an area in the outskirts of Glasgow and the objective is to identify the current provisions of maternity care and other health care services, which cater for the needs of the local population in the physical, emotional, intellectual and social needs for groups in the community, additionally, commenting on any deficits in care. Health promotions have been identified as resources that will enhance the health of this specific communitys health and are included in the profile. Also, the role and contribution of the midwifery services is explored, along with other primary healthcare providers and how they use teamwork to deliver healthcare to the community. Professional and ethical issues have been discussed throughout the profile and as all aspects of health are unrelated and interdependent, (Ewles Simnett, 1992: Ch1 p7), a holistic and professional view has been taken to evaluate the needs, and health services of this community. The RCM believes that truly woman-centered care must encompass midwifery-led care of normal pregnancy, birth and the postnatal period and services that are planned and delivered close to women and the communities in which they live or work, (NHS Evidence, 2008). This statement shows the importance of a community midwife, as their role is to not only provide the clinical skills, but also be accessible for support and advice at the time of much adjustment for a woman. If the midwife can become a part of the womans community, getting to know the woman and her family more personally, learning to understand their lives and the nature of the life around them, she will be able to be more responsive and understanding to them as individuals, and move away from the depersonalization of the institution. Individual societies each have their own specific needs and characteristics, and it is vital for a midwife to know her area well in order to respond appropriately, along with poverty levels and racial mixes (Fraser and Cooper 2009, p. 43). Community-based care can be in the home or in community hospitals and centers, but is a process that emphasizes consultation, collaboration, and referral to the professionals who are most appropriately prepared to meet the women ¹s needs (Walsh, 2001). It is also vital that women are educated and women should be given appropriate, accurate and unbiased information based on research that would allow and encourage them to make informed choices in relation to their care (Baston Green, 2002). Women from different backgrounds, and areas can often have very contrasting education levels and as a midwife, it is essential to know your neighborhood well in order to take these into consideration when communicating with a woman. The area chosen for this community profile is in the south west of Glasgow, which will now be referred to as area X, with a population of 10,024 (RDC Registrar Generals Census, 2001). Table 1: Age Distribution Area X Indicator Number Percentage Population aged 0-15 2,400 23.9% Population ages 16-64 6,463 64.5% Population aged 65+ 1161 11.6% The majority of the population is in the age range 16-64 years and the relevant health care services in the community for this group are the antenatal clinics, family planning and screening clinics. Graph 1: Hospital admissions for heart disease Area X With respect to the social and economical characteristics of the area, this graph shows the volume of people admitted to hospital for heart disease in Area X. Heart disease is more accurately described now as a disease of social and economical disadvantage and poverty (Blackburn, 1991:Ch2 p36) and the major risk factors contributing to heart disease are smoking and diet. These lifestyle factors also may echo a life associated with lower social class (Bond Bond, 1994: Ch 4 p 70). Nearly half of the houses in Area X are owner occupied, and that amount can be split into two; ex-council houses and private housing estates. The other half are tenanted homes, renting either from the council or private renting. Almost a quarter of all homes in the area suffer from overcrowding. These statistics indicate there are many occupants of tenement flats and these tend to be low-income families who have little or no choice about the type or standard of accommodation they live in (Blackburn, 1991). Higher income groups tend to live in the private housing sector, and have choices in the location and type of heating which are important influences affecting the health of families (Lowry, 1991). Table 2: Housing Area X Indicator Number Percentage Owner Occupiers 1,851 41.1% Overcrowding 1,000 22.2% (RDC Registrar Generals Census, 2001). Glasgow is home to the most workless households in the UK, according to the Office for National Statistics, (ONS). Figures measured in 2007 indicate 29% of households in the Glasgow City council area had members of working age who were unemployed (BBC, 2009). Area X also has a high percentage of people unemployed according to Scotlands Census from 2001, with both those who are unemployed and claiming and those who are economically inactive. Long-term unemployment can be a self-perpetuating cycle that leads to low morale and poor health (NHS: Greater Glasgow, 2005). Other effects of unemployment are the increased rates of depression, particularly in the young-who form most of the group who have never worked (BMJ, 2009). It is obvious from this that unemployment can alter both our mental and physical state, and in Area X almost 40% of the population of children live in a workless household, which would also have an influence on these childrens quality of life. Table 3: Unemployment Area X Indicator Number Percentage Unemployed Claimants 360 5.8% Economically inactive 3,128 43.6% Children in workless households 1.010 38.9% (RDC Registrar Generals Census, 2001). The role and contribution of midwifery services in Area X are vital in supporting childbearing women and their families, through a holistic approach. It is very important that midwives had a good understanding of social, cultural and context differences so that they can respond to the womens needs in a variety of care settings This is attained by an integrated midwifery service being part of an expert multidisciplinary team, allowing midwives to draw on other organizations to meet the holistic needs of individual women and providing a complete range of services. (Fraser Cooper 2009, p. 7). Midwives in Area X use the local hospital, and local health centers for antenatal and postnatal clinics, as well as parentcraft classes, working along side hospital doctors and GPs. The GP usually confirms the pregnancy and thereafter, an appointment is given to the woman to be introduced to the community midwife for a Booking visit, as these midwives often better understand social situations through working in the area. The women are generally referred, by the GP, to either the local hospital or a nearby health clinic to meet one of the midwives who work in Area X. These midwives work in teams of around 5, covering 2 or 3 certain postcodes in Glasgow each, and each team named after a colour to make it simple for women and their families to understand which group of community midwives they will be receiving care from, e.g. The Blue Team. This system also works well as it allows a certain degree of continuity as each woman will only be seen by the community midwives in her allocated t eam. Continuity of carer and care has been a key policy principle since the early 1990s. Research evidence demonstrates that women value continuity of carer in the antenatal and postnatal period (Waldenstrom Turnbull 1998, Homer et al 2000, Page 2009). Working in Area X requires a high level of continuity in care as it has a lower social class and experiences problems related to pregnancy such as 49.9% of the population of Area X are smokers. Other statistics for Area X include 38.6% of women smoking during pregnancy, a total of 160 women over a 3 year total. It is well known by midwives and obstetricians that smoking in pregnancy is associated with well recognized health problems and as midwives usually have the most professional contact with pregnant women, they have an important role in providing this advice and support (Buckley, 2000). Glasgow has a very well-organised network of smoke-free pharmacy services who provide NRT for smoking cessation services. They monitor carbon monoxide levels on a weekly basis and only dispense NRT if the breath test is negative (Mcgowan et al, 2008). Smoking cessation services are provided for Area X by specialist midwives, allowing continuity during pregnancy. These midwives speak to the woman and let them know what is available, without pushing them into quitting, and find out what their thoughts and feelings are, focusing on how good it is when women want to stop smoking. The chief executive of ASH Scotland, Sheila Duffy, stated in 2010 life expectancy, health problems, smoking rates, and deaths fro m smoking are all markedly different between Scotlands richest and poorest communities. Research in Scotland has found that smoking is a greater source of health inequality than social class. This shows clearly that deprived areas such as Area X are at the greatest risk of being affected by smoking issues. 43% of adults who live in deprived areas smoke, compared with 9% in the least deprived areas and this is shown in the prevalence of tobacco related diseases and deaths. 32% of deaths in Scotlands most deprived areas are due to smoking compared to 15% in the most affluent (Duffy, 2010). This is also reflected in the rates of newborn deaths as the death rate for newborn babies is more than twice as high in deprived towns compared with affluent areas and the high rate of deaths in poor areas was linked to premature delivery or birth defects (BBC, 2010). This leads on to why so many pregnant women smoke in deprived areas, such as Area X. Smokers typically report that cigarettes calm t hem down when they are stressed and help them to concentrate and work more effectively (Jarvis, 2004), and this prospect could be highly desirable to those suffering from stress and anxiety due to financial problems and other socio-economic factors such as low employment, high crime rates, poor housing and poor health care. Graph 2: Nicotine intake and social deprivation. Data from health survey for England (1993, 1994, 1996) As reported in the recent Midwifery Practice Audit 1996-1997 (END, 1997), midwives are the lead professionals in providing care for childbearing women. However, midwives need to acknowledge that other health-care professionals also contribute to each womans experience. Midwives work together with other professionals within the primary health-care team, providing integrated approaches to care delivery. Midwives have to use their own skills and expertise with the knowledge of how to access the expertise of other practitioners when required, allowing the women to receive holistic care (Houston S M, 1998). In the recent programme of work Midwifery 2020, a statement was made that women should be cared for in a multi-agency and multi-professional environment and NHS providers should have a collaborative working relationship with all other agencies based on mutual trust and respect to ensure that women and families receive optimum support. They should also ensure clear understanding of role s and facilitate effective communication between professionals and other agencies (Midwifery 2020, 2010). The first booking visit for antenatal care is important and a successful visit lays the foundation for building that special relationship between mother and the midwifery services on which so much depends (Cronk Flint, 1989:ch2 p9). The visit enables the midwife to establish any physical, psychological or social needs that will form the basis of the womans plan of care. In area X, the booking visit also allows midwives to inform the woman about the Healthy Start programme. Healthy Start is the Department of Health Welfare Food Scheme that helps pregnant women and eligible families, with children under 5, buy milk, fresh fruit and vegetables, infant feeding formula milk, and receive free vitamin supplements (NHSGCC, 2010). This is a clear example of how health services have integrated to allow women all the benefits they are entitled to, helping them achieve the best possible ex perience throughout their pregnancy. As the pregnancy progresses, parentcraft education classes are offered to prepare women for the birth experience (Jamieson, 1993) and raise awareness to the advantages of breastfeeding, giving support to mothers who choose to breastfeed. Area X presents midwives with many teenage pregnancies and antenatal services should be flexible enough to meet the needs of all women, bearing in mind the needs of those from the most disadvantaged, vulnerable and less articulate groups in society are of equal if not more importance (Lewis, 2001). As Area X is a deprived area, this contributes greatly to the teenage pregnancy statistics and throughout the developed world, teenage pregnancy is more common among young people who have been disadvantaged in childhood and have poor expectations of education or the job market. Teenagers seem to be more likely to have sexual intercourse if they come from the lower social classes or unhappy home backgrounds. Another explanation may be that many young people lack accurate knowledge about contraception, STIs, what to expect in relationships and what it will mean to be a parent (Allen, 2002). There are also serious psychological concerns related to teenage pregnancy, which the midwives in Area X must address while working with these girls. The teenage years are a time of much change and difficulty without the added stress and anxiety of a pregnancy, birth and finally motherhood. It is a midwifes duty to give the necessary advice and proper holistic care, hopefully improving the service provision and having a good obstetric outcome. Comprehensive holistic antenatal care programmes specifically for pregnant teenagers have been found to be effective in reducing poor maternal outcomes (Fullerton, 1997). For teenage pregnancies in Area X, there is a specific midwife who will be contacted at the booking visit and will be a support network for girls 18 and under, available at all times for advice, encouraging continuity and individualized, spec ific care for young mums. To conclude, through writing this community profile on Area X, I have discovered how difficult it is to work as a midwife in the community, especially in a deprived area such as Area X. From reading a large variety of articles on the psychological and social effects of poverty on pregnancy, there is much evidence that poverty has a significant effect on midwifery practice, and these women need the best care plan possible to ensure a positive experience. By having an awareness of the restrictions poverty can inflict on pregnancy and childbirth, the midwife can adapt her skills and provide care accordingly, keeping in mind aspects such as smoking during pregnancy and teenage pregnancies (Salmon et al, 1998). There is a reoccurring trend throughout this community profile confirming the link between lower socio-economic status and adverse pregnancy outcomes, such as prematurity, and the midwife is ideally placed to help identify and manage stresses, as it has been a very important conseq uence for the health and wellbeing of both mother and infant (Alderdice Lynn, 2009). Working in Area X on clinical placement has given me an insight into the importance of individualized care, as every woman is in a different situation and therefore has different needs, socially and psychologically. Some women may need more specialized care and support than others, however they are all of equal importance. Investigating the role of the midwifery service in Glasgow has opened my eyes to how both the midwives and the primary health care team deals with problems, and how without integrating health services, it would not be possible to give women the best possible care. Only by working as an integrated team with users will health inequalities be reduced, social exclusion be limited and public health become relevant and cost-effective (Henderson, 2002). The importance of involving women in decisions about their care has long been part of the everyday practice of midwives (Proctor, 1998) , and the importance of communication has been highlighted to me clearly throughout this community study, and through my placement, forcing me to realize how important it is for a midwife to fulfill her role. References: NHS Health Scotland (2004) Greater Shawlands; a community health and well-being profile [Online] Available at: http://www.scotpho.org.uk/nmsruntime/saveasdialog.asp?lID=604sID=1268 [Accessed 16 December 2010] NHS Greater Glasgow, South East Glasgow Community Health and Care Partnership (2006) Health Improvement Plan 2006-07 Draft [Online] Available at: http://library.nhsggc.org.uk/mediaAssets/library/health_improvement_plan_2006-07_south_east_glasgow.pdf [Accessed 20 December 2010] NHS Evidence National Library of Guidelines (2008) Women centered care (position statement) [Online] Available at: http://www.library.nhs.uk/GUIDELINESFINDER/ViewResource.aspx?resID=30150 [Accessed 2 January 2011] Griffin K, Maternity, Gateshead Health NHS (2009) Pregnancy: Weight Matters [Online] Available at: http://www.gatesheadhealth.nhs.uk/patients-visitors/patient-leaflets/documents/Obstetrics/IL206%20Pregnancy%20Weight%20Matters.pdf [Accessed 2 January 2011] Fraser D M Cooper M A eds (2009) Myles Textbook for Midwives 15th ed. Churchill Livingstone, London Nursing Midwifery Council (2008) The code in full [Online] Available at: http://www.nmc-uk.org/aArticle.aspx?ArticleID=3056 [Accessed 2 January 2011] Walsh L V (2001) Midwifery: Community-Based Care During the Childbearing Year Saunders, USA Baston H A Green J M (2002) Community Midwives role perceptions British Journal of Midwifery, Vol 10, No1 Community Councils Glasgow, Arden, Carnwadric, Kennishead Old Darnley (2008) Local history and Geography [Online] Available at: http://www.communitycouncilsglasgow.org.uk/dack/PlainText/PlainText.aspx?SectionId=4bf12ad1-a06e-4f7f-9a24-1f7fc2522504 [Accessed 3 January 2011] Bond J Bond S (1994) Sociology and Health Care (2nd ed), Ch 4, p 70, Churchill Livingstone, Edinburgh Cronk M Flint C (1989) Community Midwifery: A Practical Guide, Ch2, p 9, Heinemann Nursing, Oxford Ewles L Simnett I (1992) Promoting Health: A Practical Guide, (2nd ed), Scutari Press, Middlesex Fuller G, Award Finalist: NHS Greater Glasgow (2005) Complementary Medicine [Online] Available at: http://www.cipd.co.uk/NR/rdonlyres/FAD0C2B3-5901-4AE5-A1B9-4524C770521B/0/pmawrd05nhs.pdf [Accessed 2 January 2011] BBC News Scotland (2009) Glasgow has the worst UK unemployment [Online] Available at: http://news.bbc.co.uk/1/hi/scotland/8000029.stm [Accessed 3 January 2011] Lowry S (1991) Housing and Health, British Medical Journal, London Blackburn C (1991) Poverty and Health, Ch 2, pp32-36, Open University Press, Buckingham Dorling D, BMJ (2009) Unemployment and Health [Online] Available at: http://www.bmj.com/content/338/bmj.b829.full [Accessed 3 January 2011] Houston S M (1999) Multi-professional education programmes in midwifery British Journal of Midwifery, Vol 7 No 1, p 32 NHS Scotland, Midwifery 2020 (2010) Core role of the Midwife Workstream [Online] Available at: http://www.midwifery2020.org/documents/2020/Core_Role.pdf [Accessed 4 January 2011] Homer, C et al. (2000) What do women feel about community based antenatal care? Australian and New Zealand Journal of Public Health, 24, pp. 590-595. Buckley E R (2000) Helping pregnant women stop smoking British Journal of Midwifery, Vol 8 No 10, pp. 101-103 Mcgowan A, Hamilton S, Barnett D, Nsofor M, Proudfoot J Tappin J M (2008) Breathe: The stop smoking service for pregnant women in Glasgow Midwifery 26, e1-e31, Elsevier, Glasgow ASH Scotland, Duffy S (2010) Deaths from smoking in deprived areas double that of affluent [Online] Available at: http://www.ashscotland.org.uk/media/recent-press-releases/deaths-from-smoking-double-in-deprived-areas [Accessed 4 January 2011] BBC News Health (2010) Newborn deaths higher in deprived areas [Online] Available at: http://www.bbc.co.uk/news/health-11899900 [Accessed 4 January 2011] Jarvis M J (2004) Why people smoke British Medical Journal, Vol 328 No 7434 Lewis, G (ed) (2001) Why Mothers Die 1997- 1999: the fifth report of the confidential enquiries into maternal deaths in the United Kingdom. London: RCOD Press Fullerton D (1997) Preventing and reducing the adverse effects of teenage pregnancy. Health Visit 70(5): 197-9 Allen E J (2002) Aims and associations of reducing teenage pregnancy British Journal of Midwfery, Vol 11 No 6, pp.366-367 Salmon D Powell J (1998) Caring for women in poverty: a critical review British Journal of Midwifery, Vol 6 No 2, pp. 108-111 Alderdice F Lynn F (2009) Stress in pregnancy: identifying and supporting women British Joural of Midwifery, Vol 17 No9, p 553 Proctor S (1998) Womens reactions to their experience of maternity care British Journal of Midwifery, Vol 7 No 8, p 492 Henderson C (2002) The public health role of a midwife British Journal of Midwifery, Vol 10 No 5, p 268

Determining Ka by the half-titration of a weak acid Essay

To get the Ka of acetic acid, HC2H3O2 I will react it with sodium hydroxide. The point when our reaction is half-titrated can be used to determine the pKa. As I have added half as many moles of acetic , as NaOH, Thus, OH- will have reacted with only half of the acetic acid leaving a solution with equal moles of HC2H3O2 and C2H3O2-. Then I will use the Henderson-Hasselblach equation to get pKa. CH3COOH + NaOH H2O + NaCH3COO Results: Below is a table that summarizes our results for the reaction of 1M of acetic acid with 1Molar of NaOH which 50cm3 was used. The table shows the PH record at  ½ equivalence and at equivalence. We also recorded the observations we saw during the reaction. PH  ±0.1 Qualitative observations At  ½ equivalence 5.0 When I recorded this, as we slowly added NaOH to the acid, there was a change of color from colorless to a very slight pink as the Phenolphthalein indicator changed color. At equivalence 8.9 As I added the acetic acid to 250 cm3 of reaction mixture, there was no color change. Also as we measured the PH, the PH changed slowly but then changed very quickly at the solution approached equivalence. At this time, the indicator turned pink, when equivalence was reached Calculating the PKa To calculate PKa, we will use the Henderson-Hasselbalch equation. Hence the calculations below show how using this we can calculate the PKa = PKa + But at the half equivalence, the concentration of acetic acid and its salt ion are the same. Thus, we get: = PKa + = PKa Now the PH was, so PKa= 5.0  ±0.1 = 5.0  ± 2% 5.0  ±2% = = 10-5  ±2% Titration curve: To get error we are going to sketch a titration curve, and from this measure the PH at half equivalence. To do this: PH of acetic acid (1M): Ka = = 10-4.76 = √(1Ãâ€"10-4.76) So PH of acetic acid= 2.38 Now PH of NaOH, (1M) Now concentration of NaOH, was 1M So = 1 = -log(1) = 0 ±0.2% So PH= 14 ±0.2% Thus with these results we can plot this: Volume of NaOH (0.2%) PH of solution ( ±0.2) 0 2.38 45 14 48 14 50 14 We know that at volume of NaOH of 45 and 48, the PH will still be 14 as it’s in excess by far, thus getting to the PH of NaOH as the PH measured The PH of the solution has uncertainty of  ±0.2, as this is the smallest division of our y-axis in our titration sketch. Now after plotting our titration results, we can see that the equivalence point the volume was at a volume was at 28cm3 as it has the steepest gradient. Thus, the half-equivalence is at half a volume, 14cm3. At this volume the PH is 4.8  ±0.2 Using this value, as = PKa + = PKa PKa= 4.8  ±0.2 4.8 ±4.2% = = 10-4.8  ±4.2% Conclusion: I have concluded that the of acetic acid is -5 ±2% just using the data recorded (method 1). However from using that data and calculating the pH of acetic acid and NaOH, and then plotting a titration curve (method 2), we got a of 4.8 ±0.2%. As I calculated both I can calculate the % error of both comparing it with the actual value, -4.76.[1] % error of method 1= = 100  ±5% % error of method 2= = 100  ±0.84% The data I have concluded and summarized above is backed up by the data produced in the experiment and trends seen. We conclude that method 2 is more accurate as the % error is less and that our oringal method had  ±5% error. This is clearly backed up in our %errors as 4.8 is much closer to the actual value 4.76. The data that supports our % errors is the graph. It clearly shows a trend that as the volume of NaOH increased the PH rose, and the higher gradient signaling the equivalence point was at 28 cm3. Thus the graph clearly showed a half-equivalence point of 4.8 PH. Also the graph bolster that the PH at half-equivalence had to be less than 6, thus supporting the PH obtained by method 1, and hence the PKa obtained. Finally as for method 1, we simply recorded two results; we know that the datum that determined our percentage error was 5.0, and hence this data is what supports our %error. Finally the confidence level for my conclusion is good. I got the results expected, as method 2 will always be more accurate than method 1 as the latter depends too much on qualitative and subjective recordings. Thus my confidence level for such conclusion is good. Also my confidence levels on the %error and PKa for method 1, is high as 5% error was small. Thus due to this low %error, my confidence level of the experiment done for method 1 is high. Even more the PKa obtained by method 2, has a higher confidence level as the % error was barely 0.84%. Thus method 2, has excellent confident level for its extremely low %error. However the first factor that affects my confidence level is uncertainties. From the %error of PH, we got the %uncertainty of the PKa for method 1. Thus, we know, that from the total % error of 5%, 2% was made by systematic errors i.e uncertainties in this case. Thus the other 3% was caused by random error. Similarly, for method 2, we got % uncertainties for the PH by the volume measure of NaOH. This %error was 4.2%, meaning 4.2% of the total error was caused by systematic error of the graph. Clearly this is bigger than the total %error of 0.84%. Thus this means that actually, even if our graph has on the y-axis an uncertainty of  ±0.4, this is an over-estimate. This is since, while we can read a value off with this uncertainty, it can still be very close to the actual half-equivalence PH. Thus this increases my confidence level, as it shows, that the systematic error of the graph y-axis uncertainty is very limited. Thus the biggest error is random error. This occurs when estimating the equivalence point from the titration graph, which is random error as it’s an estimate of the steepest point and hence has no uncertainty. Thus as we could underestimate or overestimate this value, it creates error, as we calculated the half equivalence from it. In this case, clearly we overestimated it as; the PKa from this method is higher than the actual one. Hence this error is directly reflected in our results limiting confidence levels. Thus now we know what caused the % error for our methods. Hence, now my confidence level will increase as I know what type of error must be targeted to reduce most error. The random errors and systematic errors that constitute these percentages will be explained below, in the evaluation. Evaluation: From the results it is clear error was limited for method 1, 5%. We calculated that uncertainties make up at least 2% of that error. Thus systematic error only makes 2% of the error while random error makes 3% of the error. Thus the significant error is random errors. This was due to the subjectiveness at seeing the half-titration points. As we relied on the fact that the phenolphatlein made the solution light pink, it was difficult to see such color change. Thus it was very easy to keep adding base, when there was already a color change. Hence our error was that we could overshoot the titration. As we added to much NaOH the color change seen was too much. So when we added the acetic acid, the PH at half-equivalence is higher so we overestimated the PKa. This was reflected directly on our results. Finally another less important random error was that pipettes leaked. Thus more NaOH was added. This while small also explains why we overestimated the PKa, as we overshooted the titration even more. Finally our less significant errors were systematic error. They only make 2% of our errors. They were mainly caused by inaccuracy of our apparatus. The main systematic error caused was by the PH probe. The PH probe, first of all has great inaccuracy recording PH with a  ±0.1 uncertainty. Thus as the PH recorded was small, the %uncertainty calculated is much bigger than it would be with a higher PH. The other uncertainty was caused by the inaccuracy of pipettes. When we measured the volume of the acetic acid, there was a systematic error as Burets have uncertainties of,  ±0.10 cm3. Thus at a volume we measured of acetic acid at 25cm3, we had 0.4% error caused. We can also analyze improvements for method 2. We used this method and generated it from data we had form method 1. However, the titration sketch clearly was much more accurate than method 1, as it yields 0.84% error of which 0.2% was caused by uncertainties. Thus as we got the results for the titration curve from method 1, the error that caused the systematic errors were the same. However the main cause of error is the random error. At calculating the equivalence point, we had to estimate the point with the maximum gradient. As this is subjective, there is human error. Hence, when we then halved that volume, we could overestimate or underestimate the error since we estimated the point with maximum gradient. Improvements: To reduce the random error firstly we must do more trials. Just by doing this, we will reduce the random error. Finally as the problem with the color change was that it was a qualitative observation. To improve this we can get a quantitative measurement. To do this we use a colorimeter. This is a device we will put behind the solution. This measures the exact absorbance or transmission of light. Thus as the light absorbance changes when there is a color change, when the colorimeter states such we know that the color change has occurred. Hence we know exactly the equivalence points. The significance of this improvement is that it would enable us to get qualitative results. Thus if the colorimeter very accurate we can decrease random error, as there is no human error. Also, as the colorimeter is accurate, systematic error will also be limited. Another way we can improve is in the systematic errors. The first problem was measuring accurately volumes. As the pipettes had big uncertainties, the volume recorded had high %uncertainties. If we however use micropipettes, which have  ±0.01 cm3 uncertainties, our volumes will be extremely accurate. Hence %uncertainties will be minimal. Also micropipettes allow much easier for drops of base to be dropped. Thus the significance of this improvement is that when we measure volumes, the equivalence point will occur, more exactly as we will be less likely to overshoot the solution. Finally to solve the inaccurate measurements of PH we can get a PH sensor and data logger. These do real-time measurements and will state the PH with less uncertainty. It will also provide an alternative method for calculating the half-point. As the data logger draws the graph of the titration done, it can calculate the point with the highest gradient. Thus this will be the equivalence point. Hence we can calculate the PH at half the equivalence point of the graph as this is half the volume of base at equivalence. Thus clearly calculating a very accurate PH from the curve. The significance of this will be that it is a major improvement on method 2 and 1 as it is not qualitative. Thus it does not allow for human error. Hence as the sensor is also very accurate systematic error will also be limited as well as random error. Thus this method will get a very accurate PKa with low systematic and random errors.

William Shakespeare s The Tempest - 1256 Words

William Shakespare’s The Tempest introduces a dynamic and colorful protagonist, Prospero. Throughout the play, he establishes himself as a multi dimensional character. Prospero’s interaction with other characters in the play is vital in uncovering the many different sides of his personality. Prospero displays a different part of his personality when he interacts with Caliban, Ariel, and Ferdinand, all of whom are ploys in his master plan to regain his crown. Prospero assimilates his personality to reflect those who he is interacting with in order to manipulate them into helping him fulfill his own agenda of reclaiming Milan from his brother. Prospero’s authoritative nature can be seen as a parallel to the behavior of New World colonists,†¦show more content†¦Prospero’s interaction with Caliban may at first be seen as cruel and inhumane. Neverthless, Prospero does not denounce Caliban without reason and even teaches Caliban a helpful skill, the ski ll of language. Prospero’s relationship with Caliban shows the readers the cruel side of Prospero while simultaneously depicting his reasonable side. This interaction is similar to the interaction between colonists and the New World natives. Colonists would arrive on new and unknown lands and befriend the natives to gain knowledge about the new terrain. But, once the colonists had no use of the indigenous people, they were enslaved and used to the advantage of the mother country. Another character that Prospero has an authoritative relationship with is the spirit of Ariel. Nevertheless, Prospero’s relationship with Ariel is less brutal than his relationship with Caliban. Prospero also commands Ariel to do things for him that will make it easier for him to regain his crown, however, Prospero gives Ariel an incentive for complying with his rules. Throughout the play, Prospero promises Ariel that after he gets his dukedom back, Ariel will be set free to do as he pleases o n the island. While Prospero does abide by his promise in the end, he strings Ariel along for a long time before actually following through with his word. Prospero keeps adding another taskShow MoreRelatedWilliam Shakespeare s The Tempest1267 Words   |  6 Pagesaudience. During the Enlightenment Era, William Shakespeare’s writing were a form of social commentary on the English Government. Endorsed by the king, Shakespeare’s works told tales of tragedy and whimsy, incorporating both fiction and nonfiction elements. One trademark of Shakespeare s plays were the subtle allusions to the concurrent events in the English government. This is evident in his well known and final play, The Tempest. The story of The Tempest tells the tale of Prospero, a fallen dukeRead MoreWilliam Shakespeare s Tragicomedy The Tempest1935 Words   |  8 Pagesstand alone, frequently including elements from other influences. 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Caliban states, â€Å"This island’s mine by Sycorax my mother, (1.2.331), whic h means that he has inherited this island from his mother. However, critic Stephen Orgel has argued that â€Å"Power, as Prospero presents it in the play, is not inherited but self-createdRead MoreWilliam Shakespeare s The Tempest947 Words   |  4 PagesIn Shakespeare’s The Tempest, Caliban is the primitive monster who belongs to the bottom of the power hierarchy on the island claimed by Prospero. Caliban, the original inhabitant of the island, unwillingly becomes Prospero’s slave as he uses magic to take control of the island. Prospero sees Caliban as the savage and monster who does not acknowledge the order of civilization despite his efforts to educate him. Caliban appears as an inferior and beast-like figure from nature in the eyes of the civilizedRead MoreWilliam Shakespeare s The Tempest Essay987 Words   |  4 Pagesâ€Å"The rarer action is in virtue than in vengeance† (5.1.35-36). 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Active And Working Managing Acute Low Back Pain Essay

CHAPTER 2 Literature Review ACTIVE AND WORKING: MANAGING ACUTE LOW BACK PAIN IN THE WORKPLACE Nearly every working adult has experienced back pain in their life. Acute back pain is very common especially for working adults. Nine out of ten people will feel either an acute or severe back pain at some time in their lives. The usual thinking of people is that if you are experiencing back pain, you should rest and just lie down. But if it is possible, it helps when you still stay active and at work to speed up recovery (National Health Committee, 2000). Back pain doesn’t only affect the person by the pain he/she feels but also affects his work for he/she may lose work time because of it. Not only does an individual suffer through the pain but also suffers through the financial instability due to that pain (National Health Committee, 2000). The onset may have been with work, home or sport activities – or it may even occur for no known reason. It often starts with an activity of daily living that might not have cause any pain before. Acute back pain can also be caused by an accident such as slipping or falling (National Health Committee, 2000). Many studies have been done and there are still debates over the risk factors for back pain. There is some evidence that heavy lifting that strains the back, sudden and forceful movement, bending while bearing weight, and lots of lifting are some factors. Furthermore, gender, age, hereditary and body built makes no or little difference.Show MoreRelatedThe Care Of A 68 Year Old Female With An Acute Infarction2981 Words   |  12 Pages This case study details the care of a 68-year-old female with an acute myocardial infarction (MI) and other comorbidities from the original presentation of symptoms through outpatient rehabilitation. A physiologic basis of an acute myocardial infarction and relation to chronic comorbidities will be explored followed by the various stages of patient care. 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