Monday, August 17, 2020

Alumni Stories Ella Watson-Stryker, MIA 09 COLUMBIA UNIVERSITY - SIPA Admissions Blog

Alumni Stories Ella Watson-Stryker, MIA ’09 COLUMBIA UNIVERSITY - SIPA Admissions Blog Every October, Columbians around the worldâ€"alumni, students, parents, friends, neighbors, faculty, and staffâ€"come together for Columbia Giving Day, a 24-hour online fundraising event  on Oct. 26, 2016. Our alumni are deeply committed to making a real difference in the world.  To support  Giving Day,  the work our alumni do,  and to virtually say thanks to all of SIPAs alumni who take on global issues, big and small, Ill share one alumni story a week every Friday  this month.  The videos highlight the work of especially distinguished SIPA alumni, underscoring their various contributions to our society in the US and abroad. As a health promoter for Médecins Sans Frontières (Doctors Without Borders), Ella Watson-Stryker, MIA ’09 worked on the front lines of the 2014 Ebola epidemic in West Africa. “You can work really hard and sometimes it’s not enough,” she says. “But… we have to keep trying because if we’re not trying, then no one else will.”

Sunday, May 24, 2020

AngloSaxon Literature Essay - 632 Words

AngloSaxon Literature As we take a look back at the origins of literature throughout the Anglo-Saxon Period (449-1066), we see that many of their narratives, stories were simply passed down orally due to the lack of education prior to the era of Christianity. During the Anglo- Saxon Era literature initially began to be written down by the monks of the Christian Monasteries. The Anglo-Saxons contributed many details to human nature. The Anglo-Saxons named our modern day weekdays after Greek Gods. Heroism within an epic poem was often present during this period. Epic poetry was categorized as either elegiac or heroic. Elegiac poetry consists of a feeling of mourning or sorrow due to the loss or lack of something. Heroic poetry†¦show more content†¦The absolute origins of feudalism, which didn’t become into existence until the Medieval Period, began with the Anglo-Saxon belief of allegiance to their lord and king in the act of providence for the king in return for protection. These ide als lead to the importance of one, during this time period, to be recognized by many. Another Anglo-Saxon ideal demonstrated in Beowulf is the love of glory as the ruling motive of every noble life. Love of glory, fame, and recognition was important to the Anglo-Saxon culture. Beowulf’s reputation suggests, even prior to the â€Å"Wrath of Grendel† upon the Danes, that in Sweden, Beowulf’s home place, he was of heroic status. Boasting allowed, before battle, a feeling of confidence. Throughout this epic, Beowulf displays examples of boasting. Upon arrival in Denmark, he shows his heroic characteristics as he boasts before Hrothgar. He first states, â€Å"Hail, Hrothgar!† Then continues on to ask permission to battle the horrendous guardian of crime saying â€Å"Grant me, then, lord and protector of this noble place, a single request†¦Ã¢â‚¬  He also portrays heroism as he encounters Unferth, where explaining the swimming incident at Brecca allo wed him to boast about his strength and physical abilities. After successfully battling the â€Å"shepherd of evil†, Grendel, who had tormented the Danes for a long twelve years, he decided to display Grendel’s arm in the rafters of the mead-hall as evidence of hisShow MoreRelatedEssay AngloSaxon Language1062 Words   |  5 PagesAngloSaxon Language Nearly all knowledge of the English language before the seventh century is hypothetical. Most of this knowledge is based on later English documents and earlier documents in related languages (3). The English language of today represents many centuries of development. As a continuous process, the development of the English language began in England around the year 449 with the arrival of several Germanic tribes including: the Angles, the Saxons, and the Jutes (1, pRead MoreEssay about Clear Liquid Thought: The Photographs of Jim Dine4339 Words   |  18 Pages(69-73). 13 Philippe Hamon studied this fascinating aspect of the interference between photography and other visual systems of the nineteenth century, on the one hand and literature, on the other. He paid particular attention to the ways in which the various aesthetics of the imageries circulating at the time forced literature to redefine itself, and had an impact on the process of reading as well. Hamon analyzes the juxtaposition of various iconic objects in nineteenth-century French literaryRead MoreParental Influence on Children’s Talent Development- a Case Study with Three Chinese American Families10068 Words   |  41 PagesProfessor in Early Childhood Department at the Hong Kong Institute of Education. Journal for the Education of the Gifted. Vol. 32, No. 1, 2008, pp. 100–129. Copyright  ©2008 Prufrock Press Inc., http://www.prufrock.com Parental In uence on Children Literature on cultural matters in education has provided the premise that di erent cultures present di erent tools, habits, and assumptions that signi cantly in uence human thoughts and behavior (Tweed Lehman, 2002). us, people from di erent cultural backgroundsRead MoreConvergence, Divergence or Middle of the Path: Hrm Model6579 Words   |  27 PagesHarvard model (Beer et al., 1985) to contextual model (Hendry and Pettigrew, 1992; Hendry et al., 1988) to Schuler’s 5-P model (Schuler, 1992) of strategic HRM where he emphasizes on philosophies, policies, programmes, practices and processes, the HRM literature has evolved to a great extent. The Michigan model looks at human resource as a resource and advocates for its efficient utilization to meet organizational objectives and this model is based heavily on Chandler’s (1962) argument that an organization’sRead MoreCorporate identity16799 Words   |  68 Pagesassistance given by t he reviewers. This paper has been reviewed separately by the European Journal of Marketing review board. solely limited to marketing scholars. The current cross-fertilisation taking Corporate identity, place among the various literatures on the broad area of identity studies has led branding and the author to the conclusion that, in time, these distinct strands are likely to marketing coalesce and give rise to a new cognitive area of management called corporate marketing. Read MoreStatement of Purpose23848 Words   |  96 Pages............................. 30 III. 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Even though many scholars including John Locke, Adam Smith, John Stuart Mill, Arthur Lewis, Douglass North and Robert Thomas, and recently many papers in the literature on economic growth and development, have emphasized the importance of economic institutio ns, we are far from a useful framework for thinking about how economic institutions are determined and why they vary across countries. In other words, whileRead MoreChapter 10 Employment Relations copy11621 Words   |  47 Pagessome degree of industrial democracy. This is most apparent in the election of worker directors who advocate for employees’ interests in strategic decision-making at boardroom level. Worker directors are more common in continental Europe that in AngloSaxon economies. Two of the most common forms of representative participation are collective bargaining and works councils/joint consultative committees. Collective bargaining The most powerful form of representative participation is collective bargaining

Wednesday, May 13, 2020

Nutrition and Health Worksheet Essay - 1429 Words

University of Phoenix Material Nutrition and Health Worksheet Use Ch. 1 of Contemporary Nutrition, Ch. 2 of Visualizing Nutrition, supplemental course materials, the University Library, the Internet, or other resources to answer the following questions. Your response to each question should be 75 to 100 words. |What is nutrition? Why is nutrition essential to our daily lives? | |Nutrition is the necessary supplements provide by food for humans ingestion, digestive system, absorption, metabolism, transport,| |storage and excretion of those nutrients. Nutrients include environmental, psychological and behavioral aspects of the food and | |eating. Nutrients are†¦show more content†¦Depending on the type of mineral the body may | |need a larger amount to stay healthy of grow. For example, calcium is needed to provide strong bones and good health. | | | |Both vitamins and minerals boost the immune system. They also help with the growth and development of people, and allow cells and| |organs to do what is needed. For example, carrots help to promote healthy eyes. | |What does it mean to eat a balanced diet? Why is food choice important for good nutrition? | |Eating health allows a person to intake a portion of the five basic food groups on a daily basis. It also means eating a variety | |of foods and eating in moderation. This allows a person to get to maintain his or her calorie intake without consuming too much. | | | |Food choices are important and helps provide a good nutrition. Different foods provide different types of vitamins and minerals. | |If a person chose a diet that is nutrient dense; this dietShow MoreRelatedSCI220 Nutrition and Health Worksheet1775 Words   |  8 Pagesï » ¿ Nutrition and Health Worksheet Use Ch. 1 of Contemporary Nutrition, Ch. 2 of Visualizing Nutrition, supplemental course materials, the University Library, the Internet, or other resources to answer the following questions. Your response to each question should be 75 to 100 words. 1. What is nutrition? Why is nutrition essential to our daily lives? Nutrition is the science of our intake and utilization of food. Proper nutrition can help prevent or lessen the instances of disease. ImproperRead MoreHealth Problem Analysis Worksheet Essay638 Words   |  3 PagesThe competency, â€Å"Analyze determinants of health and disease using an ecological framework† was met through the exercise, â€Å"Health Problem Analysis Worksheet† and through reading Chapter 2 in the book Public Health: What it is and How it Works. The purpose of the â€Å"Health Problem Analysis Worksheet† was to pick a disease, I chose diabetes, and to determine the determinants, direct contributing factors and the indirect contributing factors. Turnock (2011, p.73) defines determinants as a scientific factorRead MorePhysical Fitness and Nutrition Worksheet854 Words   |  4 Pagesï » ¿University of Phoenix Material Physical Fitness and Nutrition Worksheet To obtain optimal health, it is critical to be physically fit and eat a healthy and balanced diet. Becoming knowledgeable about what it means to be physically fit and learning how to evaluate the nutritional value of what you eat may greatly increase your ability to improve your health and wellness. In this three-part worksheet, you identify the five components of health-related fitness, critique a recipe for nutritionalRead MorePhysical Fitness and Nutrition Worksheet Essay826 Words   |  4 PagesAssociate Level Material Physical Fitness and Nutrition Worksheet In order to obtain optimal health, it is critical to be physically fit and eat a healthy and balanced diet. Becoming knowledgeable about what it means to be physically fit and learning how to evaluate the nutritional value of what you eat may greatly increase your ability to improve your health and wellness. In this three-part worksheet, you identify the five components of health related fitness, critique a recipe for nutritionalRead MoreMethods Used For Obtaining Primary Data From My Community 25 Points1171 Words   |  5 Pagesgathered at the beginning of my project. To facilitate the process, I prepared a Data Collection Plan Worksheet and a set of questions to ensure that I get the most relevant information about my community. I refrained from asking yes or no questions and chose to ask â€Å"probing questions that will encourage my key informant to reflect more deeply on the meaning of her comments† (UCLA Center For Health Policy Research, n.d.). In addition, I drafted questions that I felt would elicit more revealing informationRead MoreCareer Research Paper : Career1677 Words   |  7 Pagesa Family Counselor. In this assignment we assess our career aspirations, and possibly alternative career paths. I filled out three worksheets for my assignment; Natural Talents, Interests Checklist, and Exploring Your Day Dreams. In filling in the natural talents worksheet, I identified that I am an athlete, a great writer, and a critical thinker. This worksheet expanded my possible career choices. After assessing my natural talents, I am capable of being successful in my numerous careers. In beingRead MoreLife Is Like A Box Of Chocolates1625 Words   |  7 Pagesa Family Counselor. In this assignment we assess our career aspirations, and possibly alternative career paths. I filled out three worksheets for my assignment; Natural Talents, Interests Checklist, and Exploring Your Day Dreams. In filling in the natural talents worksheet, I identified that I am an athlete, a great writer, and a critical thinker. This worksheet expanded my possible career choices. After assessing my natural talents, I am capable of being successful in my numerous careers. In beingRead MoreSci 220 Week 11728 Words   |  7 PagesNutrition and Health Worksheet 1. What is nutrition? Why is nutrition essential to our daily lives? | Nutrition is defined â€Å"as the science that links foods to health and disease. â€Å" Nutrition is also called nourishment that provides food for support of life. Nutrition involves the process of humans ingesting, digesting, absorbing, and excreting food substances.Food provides energy in the form of calories needed to maintain all body cells. Nutrients are the substances obtained from food thatRead MoreNutritional study worksheet Essay879 Words   |  4 Pagesï » ¿University of Phoenix Material Nutritional Study Worksheet Resource: University of Phoenix Library and the Internet Select one of the following topics to research: Coffee or caffeine Eggs Low-fat diets Low-carb diets Other nutrition topic approved by your instructor Research your topic using 2 nutrition articles that discuss your topic, but provide opposing viewpoints. Use the Internet, the University Library, or the search links provided in the Week 2 Electronic Reserve ReadingsRead MoreHistory of Nursing595 Words   |  3 PagesUniversity of Phoenix Material History of Nursing Research Worksheet There have been many influential publications, agencies, and people in the field of nursing research. Write 1–3 sentences in each cell of the table below to describe the importance, goal, or influence of each item. |Publications |First publication date and importance: | |Nursing Research |Firstpublished:1952

Wednesday, May 6, 2020

An Introduction to Macroeconomics Free Essays

Homework #1 Problem #1 Q: Use the supply and demand framework in the labor market to explain why employment has grown rapidly in the United States in recent decades while at the same time there has been a slowdown in real-wage growth. A: With the growth of both supply and demand in the US, we can see that the quantity of labor needed has increased. In the same time the wages have not increased that much, because if we have an increase in both supply and demand we will have a shift to the right of the equilibrium, which basically shows an increase in quantity of labor but not wages paid. We will write a custom essay sample on An Introduction to Macroeconomics or any similar topic only for you Order Now Problem #2 Q: In a small town of 100 people, there are 10 children under 16, 10 retired people, 60 people with full-time jobs, 3 people with part-time jobs, 3 full-time students over 16, and 4 full-time homemakers. The remaining people did not have jobs, but wanted jobs. All but one of these had actively looked for a job in the previous four weeks. What is the unemployment rate in this town? Show your work. A: 100 (total number of people) – 10 (children under 16) – 10 (retired) – 4 (homemakers who are not part of the labor force) – 3 (fulltime students) – 1 (not searching for job) = 72 people labor force 72 (labor force) – 60 (full time jobs) – 3 (part-time jobs) = 9 (unemployed but seeking jobs) Employment rate = employed/labor force = (labor force – unemployed)/ labor force = 63/72 = 0. 875 = 87. 5% Unemployment rate = unemployed/labor force = 9/72 = 0. 125 = 12. 5% Problem #3 Q: High Tech, Inc. produces plastic chairs that sell for $12 each. The following table provides information about how many plastic chairs can be produced per hour. Assume that apart from labor there are additional production cost of $2 per chair. How many workers will be hired if the hourly wage for workers is $70? A: # of Workers| Chairs Produced| Income| Prod. Cost| Wage| Net Income| 1| 10| 120| 20| 70| 30| 2| 18| 216| 36| 140| 40| 3| 24| 288| 48| 210| 30| 4| 28| 336| 56| 280| 0| 5| 30| 360| 60| 350| -50| There will be hired only 2 workers, because after one hour of production and paying for the work, with 2 workers the company will have the highest net income equal to $40. Problem #4 Q: A report indicated that the average real wage in manufacturing declined by 2% between 1990 and 2000. If the CPI equaled 1. 30 in 1990, 1. 69 in 2000, and the average nominal wage in manufacturing was $35 in 2000, what was the average nominal wage in manufacturing in 1990? A: Year| CPI| Nominal Salary| Real Salary| 1990| 1. 30| $x| $(y+2%)| 2000| 1. 69| $35| $y| Y=35/1. 69=20. 71 (Real Salary for 2000) Y+2%= 20. 71 + 20. 71*0. 02=21. 1242 (Real Salary for 1990) X= 21. 1242*1. 30=27. 4614 (Nominal Salary for 1990) Problem #5 Q: A labor contract provides for a first-year wage of $10 per hour, and specifies that the real wage will rise by 3 percent in the second year of the contract and by another 3 percent in the third year. The CPI is 1. 00 in the first year, 1. 07 in the second year, and 1. 15 in the third year. What dollar wage must be paid in the third year? A: Year| CPI| Nominal Salary| Real Salary| 1| 1. 00| 10| Y1=10| 2| 1. 07| X1| Y2=(Y1+3%)| 3| 1. 15| X2| Y3=(Y2+3%)| Y2 = 10+10*0. 03 = 10. 3 (Real Salary Second Year) Y3 = 10. 3 + 10. 3*0. 03 = 10. 609 (Real Salary Third Year) X1 = 10. 3*1. 07 = 11. 021 (Nominal Salary Second Year) X2 = 10. 609*1. 15 = 12. 20 (Nominal Salary Third Year) How to cite An Introduction to Macroeconomics, Essay examples

Monday, May 4, 2020

Shakeys Research Paper free essay sample

Introduction Shakers is the first successful pizza restaurant chain in the Philippines. In the 70s-80s, they use to feature bands, in their restaurants. try any of their thin- crust pizzas. Shakers the number 1 pizza restaurant in the Philippines. For the generations, Shakeys has been the neighborhood gathering place, where family and friends come together to share great food and good times. Where Shakeys things cup and growing with anew generation of family fun. Sherwood Shaker Johnson and his partner big Ed Plummer opened the first Shakeys pizza parlor more than 10 years ago. It all started in a remodeled grocery store on 57th and J streets in Sacramento California back in 1954. Shakey and Ed wanted to open all pizza and beer Joint, but with a little something unique. They provided delicious Shakers pizza, the cold beer and live Dixieland music for the entertainment, Shakeys pizza quickly become known as they world greatest pizza. We will write a custom essay sample on Shakeys Research Paper or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Today, Shakeys still serves the delicious pizza made famous by ours founders, using the best ingredients and dough prepared fresh, everyday. Keeping the tradition of great food and family entertainment, Shakers is giving up with exciting changes, ewly remodeled restaurants, improved and expanded menus, state of the art game rooms and expansion plans to open new Shakeys nationwide. Since its establishments, stands to be the perfect gathering place for friends and families, and indeed for anyone to enjoy great food. Chapter I Company profile In 1954, Sherwood shaker Johnson pooled his funds with those of college friend, Ed Plummer, to open the first Shakeys outlet. The building was a remodeled grocery store located at 57th and J streets in Sacramento, California. The parlor opened on Friday evening, april 30 with the help of their friends. As the ovens, were not omplete, only beer was sold the first weekend. Johnson entertained guests by playing the piano and Plummer serves the beer. With the money from the beer sales, the partners bought pizza products and began selling pizzas oon Monday. Ten (10) days later, they had fourteen employees and month later, Dixieland entertainment jazz was added. The restaurant at 57 and J streets has grossed millions of dollars and still a successful Shakeys today. With success of the first Sacramento restaurant, Johnson and Plummer opened a second Shakeys two years later in a remodeled mattreys factory on foster road in Portland Oregon. The Shakeys name and concept were already familiar due to the nightly Jazz radio program they sponsored. In 1957 Shakers service companies began franchising. Opening that year were franchised Marysville, California. The franchise units also introduce a standed Shakeys building design. Prior to it, the restaurants have always been located in existing remodeled structures. Shakers began to expand outside the United States with the opening of Mexico City restaurant on May 7, 1968. The first Japanese restaurant opened in Osaka, Japan on July 26, 1976. Expansion continued with a restaurant in Makati, Philippines in 1975. Today there are over 500 Shakers restaurant world wide. Pizza is stilled the mainstray at todays Shakers, whether its our original thin crust version with its crispy, crunchy taste or the classic hand tossed pizza with dough bake thick and chewy.

Monday, March 30, 2020

Spenser(protagonist)-Spenser, A Former Boxer, Is A Private Detective F

Spenser(protagonist)-Spenser, a former boxer, is a private detective from Boston. He is a very down to earth man, who likes to have fun in his work. He is very humorous and takes life as a fun ride. There is a point in the story where a larger man who attempts to intimidate Spenser, who responds by taking the large man down with one kick, all the while laughing at the man. Susan-Spenser's girlfriend who has a Ph.D. in psychology from Harvard. She is a clinical psychologist, who has been romantically involved with Spenser for many years. She often helps him on his cases when he is dealing with a disturbed or possibly dangerous person. She helps Jill Joyce overcome her problems in this novel. Jill Joyce-typical overzealous television star. She is extremely pampered and feels that it is her right to be waited upon. She has lead an extremely rough life, from abandoning her parents to having an illegitimate child. She has tried to keep this from ruining her reputation, so she is very quiet when it comes to her past. Hawk-is a large, intimidating black man who was born in a ghetto, served with the French Foreign Legion, and was a boxer during the same period as Spenser. His occupation is 'enforcer', collector for loan sharks; he will murder for money, which he makes a lot of. Plot Synopsis- Spenser is hired by Zenith Meridien Television to guard Jill Joyce. She has experienced harassment in the recent past, and the company wishes for her to feel safe on the set. Spenser finds that Jill is a troubled, alcoholic, drug addicted, egocentric annoyance that is lost in life. The morning after they meet, a Mr. Rojack and his thug, Randall try to get Jill to go with them. Jill declines their offer, at which point, Randall attempts to attack the smaller Spenser, only to find himself on the ground within moments. Later that week, Spenser tracks down Rojack, who turns out to be quite wealthy and discovers that Rojack and Jill had more or less gone steady for a couple years. He also learns of Winfred Pomroy, a man who had been "bothering" Ms. Joyce. He makes plans to visit this man, as it may provide an idea to the identity of the assailant. The following morning, Spenser and Jill discover Babe Loftus, who was Jill's stunt double, murdered in her dressing room. This provokes spenser to take quicker action, and he sets out for Pomroy's home. While he is gone, he has a friend of his, Hawk, look after the starlet. When Spenser visits Pomroy, he finds a recovered alcoholic, living with three dogs. He had been married to Jill 25 years ago and seems to be slightly obsessed with Ms. Joyce at the present. Spenser journeys to the San Diego area in search of more of Jill's past, where he finds her mother. Through her, he learns Jill conceived a daughter with a man Del Rio. Del Rio has since adopted Jill's daughter, who is now 20 years old. Spenser also tracks down Jill's father, who hasn't seen her since she was four. He briefly questions the poor, troubled man and returns home. Spenser returns to Boston only to find that Jill has run away, Then Del Rio calls and informs Spenser that Jill has escaped to see him. Spenser travels to retrieve Jill. She talks about the man harassing her. Spenser suggests they bring the father in to see Jill. Spenser then accuses him of killing Babe Loftus, the stunt-woman, to which he confesses, then tries to pull a gun on Spenser. Spenser kills him before he can do anything. Spenser and Jill return to the peaceful setting of Susan's cabin in Maine and she seems to be in hopeless condition. Susan comes, bringing the 3 dogs that Wilder Pomory had. and when they come to Jill, she responds to them, and as the story ends, she and Spenser have walked around the lake with the dogs, Jill is showing signs of emerging from her condition, where Susan may be able to help her, in fact Jill expresses interest in being treated by Susan. Opinion-This book was wonderfully written. The characters were all realistic, and they reacted as you

Saturday, March 7, 2020

Compartment syndrome Essays

Compartment syndrome Essays Compartment syndrome Essay Compartment syndrome Essay   Ã‚  Ã‚  Ã‚   COMPARTMENT SYNDROME  Ã‚  Ã‚  Ã‚   Page 1   Ã‚  Ã‚  Ã‚   Compartment syndrome is a condition that occurs when the pressure in an anatomical  compartment increases due to swelling which can cause damage to the muscles and the  nerves. As the pressure increases, it cuts off circulation and starves the muscle and nerve  cells. This can cause temporary or even permanent damage and as a result, the affected  area can develop paralysis. In severe cases, amputation of the limb may be required or the  end result could be death.   Ã‚  Ã‚  Ã‚   Compartment syndrome is classified in two different forms. It can be chronic  compartment syndrome which is a common ailment among athletes due to exercise and  physical activity. The other form is acute compartment syndrome that is a medical  emergency, generally trauma induced, where time is of the essence.   Ã‚  Ã‚  Ã‚   Compartment syndrome most commonly affects the lower leg and forearm, although it  can occur in the foot, thigh, hand and upper arm.   Ã‚     Ã‚  The first case of chronic compartment syndrome of the leg was diagnosed by Mavor  in 1956. Over the next twenty years, only nine other cases were of chronic compartment  syndrome were reported. But as physical fitness became more of a trend and grew in  popularity, chronic compartment syndrome became a more significant problem.   Ã‚  Ã‚  Ã‚   Chronic compartment syndrome generally occurs in the legs as a result of steady  exercise or running. This can generate a constant pressure to the areas in the anterior or  lateral compartments. Exertion can cause the muscles to swell and expand forcing  pressure within the compartment. Most often this occurs in the lower leg and can usually  be relieved with plenty of rest, applying ice and elevation of the affected area. Compression is not to be applied.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   COMPARTMENT SYNDROME  Ã‚  Ã‚  Ã‚   Page 2   Ã‚  Ã‚  Ã‚   Pain and swelling are the primary symptoms in chronic compartment syndrome and it  can last for weeks and even months. Diagnosing chronic compartment syndrome can be  done by testing the pressure in the compartment with a handheld pressure catheter  provided the condition exists within the anterior compartment. If the problem is deeper  into the posterior compartment, it is more difficult to test because the area is harder to  reach. Doctors measure the pressure before a person exercises, then one minute after  exercise and finally five minutes after the exercise. If the pressure has not decreased,  compartment syndrome is the likely diagnosis.   Ã‚  Ã‚  Ã‚   Thallium stress testing is another test used to detect chronic compartment syndrome. In this test, thallium is injected intravenously into the body as the patient undergoes  various forms of exercise. By use of this form of testing, multiple compartments can be  found to be affected as was proven in some cases. This test, however, does not indicate  the extent of the condition.   Ã‚  Ã‚  Ã‚   In chronic compartment syndrome, the patient often feels a numbness or tingling when  moving the affected area. This usually subsides once the movement ceases but the  pressure inside the compartment has the potential to still remain high afterwards.   Ã‚  Ã‚  Ã‚   Treatment for chronic compartment syndrome rarely requires surgery. Doctors suggest  rest and avoiding activity, especially anything strenuous or physical involving the  affected limb. Ice and elevation are recommended and the patient is to take aspirin or  ibuprofen to reduce the inflammation.   Ã‚  Ã‚  Ã‚   Should this type of treatment fail, a fasciotomy is recommended. Fasciotomy is a  surgical procedure involving the fascia, or fibrous tissue that surrounds the muscle. The  fascia is cut to relieve the pressure in the compartment. The procedure has a high rate of  success but many patients require skin grafts to heal the surgery site.   Ã‚  Ã‚  Ã‚   Chronic compartment syndrome can result from running, a change in physical activity,  exercise without proper stretching, the use of braces and wrapping or taping a limb too  tight.   Ã‚  Ã‚  Ã‚   Acute compartment syndrome is the more severe form of this injury. It is generally  caused due to some sort of trauma to the compartment. Bone fractures, tearing the muscle  itself, blood clots and blockages, extreme workouts, anabolic steroid use and crush  injuries are typical causes of this condition.   Ã‚  Ã‚  Ã‚   While chronic compartment syndrome is not a life-threatening medical emergency,  acute compartment syndrome is extremely dangerous. It allows a four to eight hour  window in which the pressure of the severe swelling can kill off all of the capillaries and  muscle and nerve cells in the compartment.   Ã‚  Ã‚  Ã‚   Once this happens, the limb would have to be amputated or eventually death would  occur from a lack of oxygen. When acute compartment syndrome occurs from a bone  fracture in the leg or arm, the limb should not be casted until the pressure stabilizes. A  splint should be applied until the swelling recedes.   Ã‚  Ã‚  Ã‚  Ã‚   If acute compartment syndrome is not diagnosed in time and the cells in the  compartment die off, infection and gangrene will set in. This would be the reason that  amputation would be needed. Renal failure is another likely result. The tissue and nerve  cells can survive for up to four hours before the damage becomes irreversible.   Ã‚  Ã‚  Ã‚   Compartment syndrome is a condition that needs to be monitored closely for several  days following the initial injury. A patient is still at high risk for three to six days after  the initial cause of swelling in the compartment. In severe cases, a hospital stay is  required to record the frequent examinations and pressure measurements. Some studies  show that maximum swelling due to an injury may take 21 to 36 hours to peak. This is  one of the reasons that rest is particularly important because any slight increase in  pressure can trigger the need for emergency surgery.   Ã‚  Ã‚  Ã‚   Since pain is common with any injury but also a major symptom in acute  compartment syndrome, it can be interpreted wrong, tolerated and remain undiagnosed.  The pain level with acute compartment syndrome is severe. As pressure builds in the  compartment, the feeling is very tight. Movement can be excruciating as the pressure  compresses against the muscle. Skin will feel stretched and the affected area can  experience a tingling or burning sensation. Patients will also feel a palpitation in the area.   Ã‚  Ã‚  Ã‚   Once the pressure is tested in the compartment and diagnosis is confirmed, treatment  begins with complete rest, ice and elevation. During this time the muscle will feel tight  and the pain will be severe. Compartment pressures must be monitored and when the readings maintain a high number, emergency surgery is required.   Ã‚  Ã‚  Ã‚   During the fasciotomy, a long incision is made in the fascia to release the pressure. The wound is covered with a dressing and left open for 48 to 72 hours before closure. Due to this nature, skin grafts are often required to close the wound.   Ã‚  Ã‚   Acute compartment syndrome is a typical injury of motorcycle riders as a result of being run over by the bikes, thus crushing an arm or a leg. COMPARTMENT SYNDROME  Ã‚  Ã‚  Ã‚   Page 5   Ã‚  Ã‚  Ã‚   Football players also tend to be prone to acute compartment syndrome from injuries received by hard hits when helmets come in contact with the thigh during a tackle. If these injuries are not treated properly with acute compartment syndrome taken into consideration, the result can be permanent paralysis of the limb.   Ã‚  Ã‚  Ã‚   Compartment syndrome does not just affect running athletes and trauma victims. Bodybuilders and bowlers often suffer from a tightening of the muscle in the wrist. This is more commonly known as carpal tunnel syndrome. It is also a medical condition that is common among writers and typists or anyone who performs repetitive motions with their fingers and wrists. Carpal tunnel syndrome affects the muscles in the wrist creating a compartment syndrome.   Ã‚  Ã‚  Ã‚   There needs to be more of an awareness made on the symptoms, treatment and severity of compartment syndrome. People sometimes shake the signs off as a complication from the injury, expecting pain and swelling. Medical personnel involved in treating motorcycle riders and athletes should understand the depth of the injury because in the case of compartment syndrome, time is critical. REFERENCES Medline Plus (04/05/07) Medical Encyclopedia: Compartment Syndrome. Retrieved 4/12/07 fom nlm.nih.gov/medlineplus/ency/article/001224.htm Pediatric Orthopaedic Society of North America (02/05). Compartment Syndrome. Retrieved 4/13/07 from http://orthoinfo.aaos.org Swain, R. MD and Ross, D. MD 03/99. Lower Extremity Compartment Syndrome. Retrieved 04/13/07 from postgradmed.com/issues/1999/03_99/swain.htm Wikipedia, the Free Encyclopedia. (2007) Compartment Syndrome. Retrieved 4/12/07 from   http://en.wikipedia.org/wiki/Compartment_syndrome