16.17: Introduction to Sentence Structure
What you’ll learn to do: analyze sentence structure
Language is made up of words, which work together to form sentences, which work together to form paragraphs. In this outcome, we’ll be focusing on sentences: how they’re made and how they behave. Sentences help us to organize our ideas—to identify which items belong together and which should be separated.
So just what is a sentence? Sentences are simply collections of words. Each sentence has a subject, an action, and punctuation. These basic building blocks work together to create endless amounts and varieties of sentences.
In this outcome, we’ll look at the different parts that work together to create sentences and at the different types of sentences that work together to create variety in your writing.
Contributors and Attributions
- Outcome: Sentence Structure. Provided by : Lumen Learning. License : CC BY: Attribution
- Modification of Notepad. Authored by : Simon Mettler. Located at : https://thenounproject.com/term/notepad/154767/ . License : CC BY: Attribution


12.2.2: More Computing Devices
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Other Computing Devices
A personal computer is designed to be a general-purpose device. That is, it can be used to solve many different types of problems. As the technologies of the personal computer have become more commonplace, many of the components have been integrated into other devices that previously were purely mechanical. We have also seen an evolution in what defines a computer. Ever since the invention of the personal computer, users have clamored for a way to carry them around. Here we will examine several types of devices that represent the latest trends in personal computing.
Portable Computers
In 1983, Compaq Computer Corporation developed the first commercially successful portable personal computer. By today’s standards, the Compaq PC was not very portable: weighing in at 28 pounds, this computer was portable only in the most literal sense – it could be carried around. But this was no laptop; the computer was designed like a suitcase, to be lugged around and laid on its side to be used. Besides portability, the Compaq was successful because it was fully compatible with the software being run by the IBM PC, which was the standard for business.
In the years that followed, portable computing continued to improve, giving us laptop and notebook computers. The “luggable” computer has given way to a much lighter clamshell computer that weighs from 4 to 6 pounds and runs on batteries. In fact, the most recent advances in technology give us a new class of laptop that is quickly becoming the standard: these laptops are extremely light and portable and use less power than their larger counterparts. The MacBook Air is a good example of this: it weighs less than three pounds and is only 0.68 inches thick!
Finally, as more and more organizations and individuals are moving much of their computing to the Internet, laptops are being developed that use “the cloud” for all of their data and application storage. These laptops are also extremely light because they have no need of a hard disk at all! A good example of this type of laptop (sometimes called a netbook) is Samsung’s Chromebook.
Smartphones
The first modern-day mobile phone was invented in 1973. Resembling a brick and weighing in at two pounds, it was priced out of reach for most consumers at nearly four thousand dollars.  As mobile phones evolved, they became more like small computers. These smartphones have many of the same characteristics as a personal computer, such as an operating system and memory. The first smartphone was the IBM Simon , introduced in 1994.
In January of 2007, Apple introduced the iPhone. Its ease of use and intuitive interface made it an immediate success and solidified the future of smartphones. Running on an operating system called iOS, the iPhone was really a small computer with a touch-screen interface. In 2008, the first Android phone was released, with similar functionality.
Tablet Computers
A tablet computer is one that uses a touch screen as its primary input and is small enough and light enough to be carried around easily. They generally have no keyboard and are self-contained inside a rectangular case. The first tablet computers appeared in the early 2000s and used an attached pen as a writing device for input. These tablets ranged in size from small personal digital assistants (PDAs), which were handheld, to full-sized, 14-inch devices. Most early tablets used a version of an existing computer operating system, such as Windows or Linux.
These early tablet devices were, for the most part, commercial failures. In January, 2010, Apple introduced the iPad, which ushered in a new era of tablet computing. Instead of a pen, the iPad used the finger as the primary input device. Instead of using the operating system of their desktop and laptop computers, Apple chose to use iOS, the operating system of the iPhone. Because the iPad had a user interface that was the same as the iPhone, consumers felt comfortable and sales took off. The iPad has set the standard for tablet computing. After the success of the iPad, computer manufacturers began to develop new tablets that utilized operating systems that were designed for mobile devices, such as Android.
The Rise of Mobile Computing
Mobile computing is having a huge impact on the business world today. The use of smartphones and tablet computers is rising at double-digit rates each year. The Gartner Group, in a report issued in April, 2013, estimates that over 1.7 million mobile phones will ship in the US in 2013 as compared to just over 340,000 personal computers. Over half of these mobile phones are smartphones. [2] Almost 200,000 tablet computers are predicted to ship in 2013. According to the report, PC shipments will continue to decline as phone and tablet shipments continue to increase. [3]
Integrated Computing
Along with advances in computers themselves, computing technology is being integrated into many everyday products. From automobiles to refrigerators to airplanes, computing technology is enhancing what these devices can do and is adding capabilities that would have been considered science fiction just a few years ago. Here are two of the latest ways that computing technologies are being integrated into everyday products:


1.4: New Recording Technologies
Today, the ability to make high-quality recordings is within the reach of anyone with a laptop and a microphone. But only a few years ago, recordings were an expensive endeavor available only to those with the financial backing of a record label. Musicians of the twenty-first century have access not only to recording technologies, but also to new and cutting-edge tools that are fundamentally changing how music is created, enjoyed, and disseminated.
Auto-Tune and Looping
Auto-Tune is a technique originally invented to correct for intonation mistakes in vocal performances. However, the technique quickly evolved into a new form of expression, allowing singers to add expressive flourishes to their singing. Eventually, the technique was used to turn regular speech into music, making it possible to create music out of everyday sounds. Listen to the clip below of the musical group, the Gregory Brothers, who regularly use Auto-Tune to create songs from viral Internet videos and news clips.
Ex. 1.4.1 How Auto tune works
Ex. 1.4.2: Obama Mixtape: 1999 - Songify the News Special Edition
Looping is another technique that musicians now use to create music on the spot. The technique involves recording audio samples which are then repeated or “looped” over and over again to a single beat. The performer then adds new loops over the old ones to create complex musical backdrops. The clip below features a street musician named Dub FX, who uses only his voice, a loop pedal, and some audio effects to replicate the effect of a full band.
Ex. 1.4.3: Dub FX
Ex 1.4.4 BOSS RC-300 Loop Station


31.4: Chapter Summary
This chapter focused on various symptoms that may affect the gastrointestinal (GI) tract. The most common symptoms include heartburn, burning abdominal pain, and regurgitation, and they are often related to excess acidity in the GI tract. Other GI symptoms were discussed, such as bloating, a feeling of fullness, abdominal discomfort, belching, cough, nausea, and vomiting, which may occur simultaneously and may require a multifactorial approach to diagnosis and treatment. The chapter discussed different medications that may be prescribed for treatment and maintenance of these conditions. Nursing assessment and client education is imperative to the proper diagnosis and treatment of hyperacidic conditions.


1.5: Numbers in Astronomy
In astronomy we deal with distances on a scale you may never have thought about before, with numbers larger than any you may have encountered. We adopt two approaches that make dealing with astronomical numbers a little bit easier. First, we use a system for writing large and small numbers called scientific notation (or sometimes powers-of-ten notation ). This system is very appealing because it eliminates the many zeros that can seem overwhelming to the reader. In scientific notation, if you want to write a number such as 500,000,000, you express it as Système International d’Unités ). The metric system is summarized in Appendix D (see Example 1.2).
A common unit astronomers use to describe distances in the universe is a light-year, which is the distance light travels during one year. Because light always travels at the same speed, and because its speed turns out to be the fastest possible speed in the universe, it makes a good standard for keeping track of distances. You might be confused because a “light-year” seems to imply that we are measuring time, but this mix-up of time and distance is common in everyday life as well. For example, when your friend asks where the movie theater is located, you might say “about 20 minutes from downtown.”
So, how many kilometers are there in a light-year? Light travels at the amazing pace of
Scientific Notation
In 2015, the richest human being on our planet had a net worth of $79.2 billion. Some might say this is an astronomical sum of money. Express this amount in scientific notation.
Solution
$79.2 billion can be written $79,200,000,000. Expressed in scientific notation it becomes
Getting Familiar with a Light-Year
How many kilometers are there in a light-year?
Solution
Light travels km in 1 s. So, let’s calculate how far it goes in a year:
- There are 60 s in 1 min, and min in 1 h.
- Multiply these together and you find that there are s/h.
- Thus, light covers
- There are 24 or h in a day, and 365.25 days in 1 y.
- The product of these two numbers is h/y.
- Multiplying this by km/h gives km/light-year.
That’s almost 10,000,000,000,000 km that light covers in a year. To help you imagine how long this distance is, we’ll mention that a string 1 light-year long could fit around the circumference of Earth 236 million times.


11.4: Conservation of Angular Momentum
- Apply conservation of angular momentum to determine the angular velocity of a rotating system in which the moment of inertia is changing
- Explain how the rotational kinetic energy changes when a system undergoes changes in both moment of inertia and angular velocity
So far, we have looked at the angular momentum of systems consisting of point particles and rigid bodies. We have also analyzed the torques involved, using the expression that relates the external net torque to the change in angular momentum. Examples of systems that obey this equation include a freely spinning bicycle tire that slows over time due to torque arising from friction, or the slowing of Earth’s rotation over millions of years due to frictional forces exerted on tidal deformations.
However, suppose there is no net external torque on the system, \(\sum \vec{\tau}\) = 0. In this case, we can introduce the law of conservation of angular momentum .
The angular momentum of a system of particles around a point in a fixed inertial reference frame is conserved if there is no net external torque around that point:
\[\frac{d \vec{L}}{dt} = 0 \label{11.10}\]
or
\[\vec{L} = \vec{l}_{1} + \vec{l}_{2} + \cdots + \vec{l}_{N} = constant \ldotp \label{11.11}\]
Note that the total angular momentum \(\vec{L}\) is conserved. Any of the individual angular momenta can change as long as their sum remains constant. This law is analogous to linear momentum being conserved when the external force on a system is zero.
As an example of conservation of angular momentum, Figure \(\PageIndex{1}\) shows an ice skater executing a spin. The net torque on her is very close to zero because there is relatively little friction between her skates and the ice. Also, the friction is exerted very close to the pivot point. Both \(|\vec{F}|\) and \(|\vec{r}|\) are small, so \(|\vec{\tau}|\) is negligible. Consequently, she can spin for quite some time. She can also increase her rate of spin by pulling her arms and legs in. Why does pulling her arms and legs in increase her rate of spin? The answer is that her angular momentum is constant, so that
\[L' = L\]
or
\[I' \omega' = I \omega,\]
where the primed quantities refer to conditions after she has pulled in her arms and reduced her moment of inertia. Because I′ is smaller, the angular velocity \(\omega\)′ must increase to keep the angular momentum constant.
It is interesting to see how the rotational kinetic energy of the skater changes when she pulls her arms in. Her initial rotational energy is
\[K_{Rot} = \frac{1}{2} I \omega^{2},\]
whereas her final rotational energy is
\[K'_{Rot} = \frac{1}{2} I (\omega')^{2} \ldotp\]
Since I′\(\omega\)′ = I\(\omega\), we can substitute for \(\omega\)′ and find
\[K'_{Rot} = \frac{1}{2} I' (\omega')^{2} = \frac{1}{2} I' \left(\dfrac{I}{I'} \omega \right)^{2} = \frac{1}{2} I \omega^{2} \left(\dfrac{I}{I'}\right) = K_{Rot} \left(\dfrac{I}{I'}\right) \ldotp\]
Because her moment of inertia has decreased, \(I′ < I\), her final rotational kinetic energy has increased. The source of this additional rotational kinetic energy is the work required to pull her arms inward. Note that the skater’s arms do not move in a perfect circle—they spiral inward. This work causes an increase in the rotational kinetic energy, while her angular momentum remains constant. Since she is in a frictionless environment, no energy escapes the system. Thus, if she were to extend her arms to their original positions, she would rotate at her original angular velocity and her kinetic energy would return to its original value.
The solar system is another example of how conservation of angular momentum works in our universe. Our solar system was born from a huge cloud of gas and dust that initially had rotational energy. Gravitational forces caused the cloud to contract, and the rotation rate increased as a result of conservation of angular momentum (Figure \(\PageIndex{2}\)).
We continue our discussion with an example that has applications to engineering.
A flywheel rotates without friction at an angular velocity \(\omega_{0}\) = 600 rev/min on a frictionless, vertical shaft of negligible rotational inertia. A second flywheel, which is at rest and has a moment of inertia three times that of the rotating flywheel, is dropped onto it (Figure \(\PageIndex{3}\)). Because friction exists between the surfaces, the flywheels very quickly reach the same rotational velocity, after which they spin together.
- Use the law of conservation of angular momentum to determine the angular velocity \(\omega\) of the combination.
- What fraction of the initial kinetic energy is lost in the coupling of the flywheels?
Strategy
Part (a) is straightforward to solve for the angular velocity of the coupled system. We use the result of (a) to compare the initial and final kinetic energies of the system in part (b).
Solution
- No external torques act on the system. The force due to friction produces an internal torque, which does not affect the angular momentum of the system. Therefore conservation of angular momentum gives \[I_{0} \omega_{0} = (I_{0} + 3I_{0}) \omega, \nonumber\] \[\omega = \frac{1}{4} \omega_{0} = 150\; rev/min = 15.7\; rad/s \ldotp \nonumber\]
- Before contact, only one flywheel is rotating. The rotational kinetic energy of this flywheel is the initial rotational kinetic energy of the system, \(\frac{1}{2} I_{0} \omega_{0}^{2}\). The final kinetic energy is \[\frac{1}{2} (4I_{0}) \omega^{2} = \frac{1}{2} (4I_{0}) \left(\dfrac{\omega_{0}}{4}\right)^{2} = \frac{1}{8} I_{0} \omega_{0}^{2}. \nonumber\] Therefore, the ratio of the final kinetic energy to the initial kinetic energy is \[\frac{\frac{1}{8} I_{0} \omega_{0}^{2}}{\frac{1}{2} I_{0} \omega_{0}^{2}} = \frac{1}{4} \ldotp \nonumber\] Thus, 3/4 of the initial kinetic energy is lost to the coupling of the two flywheels.
Significance
Since the rotational inertia of the system increased, the angular velocity decreased, as expected from the law of conservation of angular momentum. In this example, we see that the final kinetic energy of the system has decreased, as energy is lost to the coupling of the flywheels. Compare this to the example of the skater in Figure \(\PageIndex{1}\) doing work to bring her arms inward and adding rotational kinetic energy.
A merry-go-round at a playground is rotating at 4.0 rev/min. Three children jump on and increase the moment of inertia of the merry-go-round/children rotating system by 25%. What is the new rotation rate?
An 80.0-kg gymnast dismounts from a high bar. He starts the dismount at full extension, then tucks to complete a number of revolutions before landing. His moment of inertia when fully extended can be approximated as a rod of length 1.8 m and when in the tuck a rod of half that length. If his rotation rate at full extension is 1.0 rev/s and he enters the tuck when his center of mass is at 3.0 m height moving horizontally to the floor, how many revolutions can he execute if he comes out of the tuck at 1.8 m height? See Figure \(\PageIndex{4}\).
Strategy
Using conservation of angular momentum, we can find his rotation rate when in the tuck. Using the equations of kinematics, we can find the time interval from a height of 3.0 m to 1.8 m. Since he is moving horizontally with respect to the ground, the equations of free fall simplify. This will allow the number of revolutions that can be executed to be calculated. Since we are using a ratio, we can keep the units as rev/s and don’t need to convert to radians/s.
Solution
The moment of inertia at full extension is \[I_{0} = \frac{1}{12} mL^{2} = \frac{1}{12} (80.0\; kg)(1.8\; m)^{2} = 21.6\; kg\; \cdotp m^{2} \ldotp \nonumber\]
The moment of inertia in the tuck is \[I_{f} = \frac{1}{12} mL_{f}^{2} = \frac{1}{12} (80.0\; kg)(0.9\; m)^{2} = 5.4\; kg\; \cdotp m^{2} \ldotp \nonumber\]
Conservation of angular momentum: \[I_{f} \omega_{f} = I_{0} \omega_{0} \Rightarrow \omega_{f} = \frac{I_{0} \omega_{0}}{I_{f}} = \frac{(21.6\; kg\; \cdotp m^{2})(1.0\; rev/s)}{5.4\; kg\; \cdotp m^{2}} = 4.0\; rev/s \ldotp \nonumber\]
Time interval in the tuck: \[t = \sqrt{\frac{2h}{g}} = \sqrt{\frac{2(3.0 - 1.8) m}{9.8\; m/s}} = 0.5\; s \ldotp \nonumber\]
In 0.5 s, he will be able to execute two revolutions at 4.0 rev/s.
Significance
Note that the number of revolutions he can complete will depend on how long he is in the air. In the problem, he is exiting the high bar horizontally to the ground. He could also exit at an angle with respect to the ground, giving him more or less time in the air depending on the angle, positive or negative, with respect to the ground. Gymnasts must take this into account when they are executing their dismounts.
A bullet of mass m = 2.0 g is moving horizontally with a speed of 500.0 m/s. The bullet strikes and becomes embedded in the edge of a solid disk of mass M = 3.2 kg and radius R = 0.5 m. The cylinder is free to rotate around its axis and is initially at rest (Figure \(\PageIndex{5}\)). What is the angular velocity of the disk immediately after the bullet is embedded?
Strategy
For the system of the bullet and the cylinder, no external torque acts along the vertical axis through the center of the disk. Thus, the angular momentum along this axis is conserved. The initial angular momentum of the bullet is mvR, which is taken about the rotational axis of the disk the moment before the collision. The initial angular momentum of the cylinder is zero. Thus, the net angular momentum of the system is mvR. Since angular momentum is conserved, the initial angular momentum of the system is equal to the angular momentum of the bullet embedded in the disk immediately after impact.
Solution
The initial angular momentum of the system is
\[L_{i} = mvR \ldotp \nonumber\]
The moment of inertia of the system with the bullet embedded in the disk is
\[I = mR^{2} + \frac{1}{2} MR^{2} = \left(m + \dfrac{M}{2}\right) R^{2} \ldotp \nonumber\]
The final angular momentum of the system is
\[L_{f} = I \omega_{f} \ldotp \nonumber\]
Thus, by conservation of angular momentum, L i = L f and
\[mvR = \left(m + \dfrac{M}{2}\right) R^{2} \omega_{f} \ldotp \nonumber\]
Solving for \(\omega_{f}\),
\[\omega_{f} = \frac{mvR}{\left(m + \dfrac{M}{2}\right) R^{2}} = \frac{(2.0 \times 10^{-3}\; kg)(500.0\; m/s)}{(2.0 \times 10^{-3}\; kg + 1.6\; kg)(0.50\; m)} = 1.2\; rad/s \ldotp \nonumber\]
Significance
The system is composed of both a point particle and a rigid body. Care must be taken when formulating the angular momentum before and after the collision. Just before impact the angular momentum of the bullet is taken about the rotational axis of the disk.


8.12: Suggested Resources
8.1 Entrepreneurial Marketing and the Marketing Mix
American Marketing Association: https://www.ama.org
Small Business Administration: https://www.sba.gov/
8.3 Marketing Techniques and Tools for Entrepreneurs
AMA Digital Marketing Certification: https://www.ama.org/events-training/...ification.aspx
AMA on Demand course: Digital Marketing: Delivering a Custom Experience: www.ama.org/events-training/...ce-051717.aspx
Google Ads: https://ads.google.com/home/
Google Analytics: https://analytics.google.com/analyti...on/#/provision
Hubspot Google Ads guide: https://blog.hubspot.com/marketing/google-adwords-ppc
8.4 Entrepreneurial Branding
Hubspot’s Beginner’s guide to branding: https://blog.hubspot.com/agency/deve...SHcJI2E.mailto
8.5 Marketing Strategy and the Marketing Plan
Business Model Canvas: https://strategyzer.com/canvas/business-model-canvas
Hubspot Marketing Plan templates: https://blog.hubspot.com/marketing/m...late-generator
Small Business Administration: https://www.sba.gov/business-guide/m...arketing-sales
8.6 Sales and Customer Service
Cialdini online tools: https://www.influenceatwork.com/
Hoffman Sales Training: https://sellhoffman.com/
Neil Rackman: http://neilrackham.com/
Spin Selling: https://blog.hubspot.com/sales/spin-...ultimate-guide
Zig Ziglar: https://www.ziglar.com/
The State of Customer Service: https://offers.hubspot.com/state-of-...8-5de8fcbb40c1
Cialdini, R. B. (2001). Influence: Science and Practice (4th ed.). Boston: Allyn & Bacon: Explains some aspects of the sales process in a fun and fact-based manner.


31.2: Histamine Blockers and Proton-Pump Inhibitors
By the end of this section, you should be able to:
- 31.2.1 Identify the characteristics of histamine-blocker and proton-pump inhibitor drugs used to treat GI disorders.
- 31.2.2 Explain the indications, action, adverse reactions, and interactions of histamine-blocker and proton-pump inhibitor drugs used to treat GI disorders.
- 31.2.3 Describe nursing implications of histamine-blocker and proton-pump inhibitor drugs used to treat GI disorders.
- 31.2.4 Explain the client education related to histamine-blocker and proton-pump inhibitor drugs used to treat GI disorders.
Histamine blockers, known as H2 blockers, and proton-pump inhibitors (PPIs) belong to the categories of drugs used to mitigate or hinder the production of stomach acid. These medications find widespread application in the treatment of conditions associated with heightened gastric acid secretion, encompassing gastroesophageal reflux disease (GERD), peptic ulcers, and heartburn.
Histamine Blockers
Histamine blockers, also called histamine H2-receptor antagonists or H2 blockers, have GI antisecretory action. By blocking the H2 receptors, drugs in this classification suppress gastric acid secretions and lower the hydrogen ion concentration of the gastric contents by attaching to the histamine (H2) receptor sites on gastric cells. Therefore, they prevent or treat heartburn, acid indigestion, gastric and duodenal ulcers, GERD, and hypersecretory conditions such as Zollinger-Ellison syndrome . H2 blockers are often used concurrently with antibiotics to treat H. pylori- associated peptic ulcer disease (PUD).
Link to Learning
Antisecretory Drug Therapy
This article from the Mayo Clinic helps with understanding antisecretory drug therapy and how it is beneficial in hypersecretory conditions such as Zollinger-Ellison syndrome.
Cimetidine
Cimetidine is an antisecretory medication used for short-term treatment of heartburn, erosive GERD, and gastric or duodenal ulcers. Prophylactic use of cimetidine includes prevention of stress ulcers or management of hypersecretory conditions such as Zollinger-Ellison syndrome. Cimetidine has a high selectivity for the H2 receptors on the parietal cells of the stomach. (Pino & Azer, 2023) Occupying these receptor sites inhibits all phases of basal (daytime and nocturnal) gastric acid secretion. By blocking the parietal cells, gastric acid production is reduced, raising the pH of gastric contents. This results in an indirect reduction of pepsin secretion. See drug prototype Table 31.4 for additional drug information.
Famotidine
Famotidine, a histamine inhibitor, is commonly used to treat heartburn, GERD, PUD, and hypersecretory conditions. Famotidine reduces the output of hydrochloric acid from the parietal cells, which in turn reduces the erosive damage to the gastric mucosa that may occur from hyperacidity. Famotidine is an effective prophylactic drug for stress ulcers and perioperative aspiration pneumonia. It is available orally and intravenously. See drug emphasis Table 31.3 for dosing information.
Nizatidine
Nizatidine blocks histamine at the H2 receptors of the parietal cells, significantly reducing the secretion of nocturnal gastric acid for up to 12 hours. It is an effective drug for GERD, gastric ulcers, and duodenal ulcers. Nizatidine may also be used for prevention of stress ulcers or the abolition of H. pylori. The medication is generally given twice per day for up to 8 weeks. If nizatidine is ordered daily, it is generally given at bedtime. See drug emphasis Table 31.3 for dosing information.
Table 31.3 lists common histamine blockers and typical routes and dosing for adult clients.
| Drug | Routes and Dosage Ranges |
|---|---|
|
Cimetidine
( Tagamet HB ) |
For GERD:
400 mg orally 4 times daily or 800 mg orally twice daily for up to 12 weeks.
For heartburn/dyspepsia: 200 mg orally 2–4 times daily. Reduce daily dosage by 50% if the client’s CrCl (creatinine clearance) is less than 30 mL/hour. Intermittent intravenous infusion: 300 mg every 6–8 hours infused over 15–20 minutes. Continuous intravenous infusion: 37.5 mg/hour (900 mg/day). |
|
Famotidine
( Pepcid ) |
For GERD/gastritis:
20 mg orally twice daily for up to 8 weeks.
For heartburn/dyspepsia: 20 mg orally 10–60 minutes before meals. For hypersecretory conditions: 20 mg orally every 6 hours or 20 mg intravenously every 12 hours. |
|
Nizatidine
( Axid ) |
For GERD/gastritis:
150 mg orally twice daily for up to 12 weeks.
For gastric/duodenal ulcers: 150 mg orally twice daily or 300 mg orally at bedtime for up to 8 weeks. |
Adverse Effects and Contraindications
Typical adverse effects of histamine blockers include diarrhea, headaches, mental confusion, agitation, depression, gynecomastia , neutropenia , agranulocytosis , increases in serum transaminase , arthralgia , rash, and alopecia . In rare cases, bradycardia, tachycardia, and AV heart block have been reported. Contraindications include hypersensitivity to the drug or any of its components.
Table 31.4 is a drug prototype table for histamine blockers featuring cimetidine. It lists drug class, mechanism of action, adult dosage, indications, therapeutic effects, drug and food interactions, adverse effects, and contraindications.
|
Drug Class
H2-receptor antagonists/blockers Mechanism of Action Blocks H2 receptors, thereby suppressing gastric acid secretion, and lowers the hydrogen ion concentration in the stomach |
Drug Dosage
For GERD: 400 mg orally 4 times daily or 800 mg orally twice daily for up to 12 weeks. For heartburn/dyspepsia: 200 mg orally 2–4 times daily. Reduce daily dosage by 50% if the client’s CrCl is less than 30 mL/hour. Intermittent intravenous infusion: 300 mg every 6–8 hours infused over 15–20 minutes. Continuous intravenous infusion: 37.5 mg/hour (900 mg/day). |
|
Indications
Short-term treatment of active duodenal and active benign gastric ulcers, erosive GERD, and hypersecretory conditions Therapeutic Effects Decreases gastric acids to provide symptomatic relief of hyperacidic GI conditions |
Drug Interactions
Warfarin Phenytoin Theophylline Metronidazole Ketoconazole Food Interactions No significant interactions |
|
Adverse Effects
Diarrhea Headaches Dizziness Confusion Agranulocytosis Gynecomastia |
Contraindications
Hypersensitivity Caution: Rare instances of cardiac arrhythmias and hypotension have been reported following the rapid administration of cimetidine hydrochloride injection by intravenous bolus |
Case Study
Read the following clinical scenario to answer the questions that follow.
Logan Gomez is a 35-year-old parent of two presenting to the health care provider with reports of burning in the upper part of the abdomen. The pain develops after eating. Often the pain wakes them from sleeping. Logan schedules an appointment with the provider.
| Vital Signs | Physical Examination | |
|---|---|---|
| Temperature: | 98.4° F |
|
| Blood pressure: | 118/66 mm Hg | |
| Heart rate: | 88 beats/min | |
| Respiratory rate: | 16 breaths/min | |
| Oxygen saturation: | 97% on room air | |
| Height: | 5'8" | |
| Weight: | 145 lb |
The client is diagnosed with peptic ulcer disease. Which medication does the nurse anticipate the provider will order for Logan?
- Answer
-
Famotidine
The nurse is educating the client on the newly prescribed medication. Which of the following statements by the client indicates understanding?
- Answer
-
“While I am taking this medication I will avoid alcohol, spicy foods, and ibuprofen.”
Proton Pump Inhibitor s
Proton pump inhibitors (PPIs) are antisecretory drugs that block both basal and stimulated gastric acid production. Gastric acid secretions are reduced by irreversibly blocking gastric hydrogen and potassium ATPase, an enzyme that produces gastric acid. Short-term use of PPIs for 4–6 weeks is an effective treatment for gastric and duodenal ulcers, GERD, and erosive esophagitis. The long-term use of PPIs is useful in hypersecretory conditions such as Zollinger-Ellison syndrome. Prophylactic use of PPIs is administered for clients at risk for stress ulcers, such as trauma clients on mechanical ventilation.
Omeprazole
Omeprazole is the prototype antisecretory PPI that suppresses the secretion of gastric acid by inhibiting the gastric proton pump found within the parietal cells. Various chemicals such as acetylcholine, histamine, and gastrin bind to receptors on parietal cells, prompting activation of hydrogen (H + ), potassium (K + ), and ATPase enzymes (the proton pump) that produces gastric acid secretion. Suppressing this action relieves GI distress to allow for healing of the mucosal lining.
Omeprazole is commonly used for dyspepsia (occurring at least twice per week), GERD, duodenal and gastric ulcers, erosive esophagitis, and prophylactically to prevent gastric ulcers related to the use of nonsteroidal antiinflammatory drugs (NSAIDs). Typical treatment is 4–8 weeks, along with diet and lifestyle modifications. Short-term use in combination with clarithromycin may be used to treat duodenal ulcers associated with H. pylori infections.
Omeprazole is available for oral use as a capsule, delayed-release tablet, and powder for oral suspension. Oral capsules and delayed-released tablets are best administered 30–60 minutes before breakfast. These must be swallowed whole and should not be opened, chewed, or crushed. It may take several days for omeprazole to take effect. In these cases, occasionally omeprazole is administered along with antacids until the omeprazole takes effect. Oral-suspension omeprazole may be administered via a gastrostomy tube. The omeprazole suspension contains granules that must be diluted in water. See drug prototype Table 31.7 for additional information.
Pantoprazole
Pantoprazole is a PPI used short-term for GERD and to manage or prevent erosive esophagitis. It is also useful in managing hypersecretory diseases, peptic ulcer disease, duodenal ulcers, dyspepsia, heartburn, and for stress ulcer prophylaxis. Pantoprazole suppresses gastric acid production by inhibiting the proton pump in the parietal cells.
Pantoprazole is available in delayed-release tablets, granules to create an oral suspension, and as a reconstituted solution for parenteral use. Tablets should be taken whole with or without food, without chewing, crushing, or breaking them. Granules may be administered orally or via a gastric tube. Oral suspension and granules may only be administered in apple juice or applesauce; the medication should not be mixed with water or other liquids or foods (Pfizer, 2023). However, the nurse should recommend that clients take small sips of water after administration to ensure the granules are washed down into the stomach. Pantoprazole is typically not used for longer than 8 weeks, especially in older clients . See drug emphasis Table 31.6 for dosing.
Esomeprazole
Esomeprazole is a weak base isomer of omeprazole that is converted to its active form in a highly acidic gastric environment. It inhibits the proton pump in parietal cells, significantly decreasing basal and stimulated gastric acid secretions.
Esomeprazole is an effective PPI that supports healing of erosive esophagitis, treatment of heartburn, prevention of recurrent gastric or duodenal ulcers, and ulcer prophylaxis with NSAID use. Additionally, esomeprazole is effective in the management of GERD, ulcers, and hypersecretory disease such as Zollinger-Ellison syndrome.
Esomeprazole is available in capsules, oral suspension, and powder for reconstitution for injection. The drug is destroyed in acidic environments; therefore, esomeprazole capsules are produced to allow for delayed absorption in the small intestine. Capsules must be swallowed whole and cannot be crushed or chewed. If a client cannot swallow capsules, the capsule may be opened and the capsule pellets mixed in applesauce The nurse should emphasize that the applesauce, once mixed, must be swallowed promptly without chewing the pellets to ensure the medication remains effective. Direct parenteral administration of esomeprazole must be reconstituted. See drug emphasis Table 31.6 for dosing.
Lansoprazole
Lansoprazole is a PPI that suppresses gastric acid formation, making it effective for short-term use to treat duodenal ulcers, erosive esophagitis, and GERD and as maintenance treatment for hypersecretory disorders. Lansoprazole is rapidly absorbed from the GI tract after leaving the stomach. The onset to reduce acid is approximately 2 hours. Ulcer symptom relief is generally acquired within the first week of its use. Lansoprazole is available as a sustained-release capsule and oral disintegrating tablets. See drug emphasis Table 31.6 for dosing.
Table 31.6 lists common PPIs and typical routes and dosing for adult clients.
| Drug | Routes and Dosage Ranges |
|---|---|
|
Omeprazole
( Prilosec ) |
20 mg (delayed-release or disintegrating tablet) orally once daily for 14 days. |
|
Pantoprazole
( Protonix ) |
40 mg orally once daily for 4–8 weeks or 40 mg intravenously once daily for 7–10 days. |
|
Esomeprazole
( Nexium ) |
20 mg orally or 20–40 mg intravenously once daily for 4–8 weeks. |
|
Lansoprazole
( Prevacid ) |
15 mg orally once daily 30 minutes before a meal for 14 days. |
Adverse Effects and Contraindications
Typical adverse effects include headache, dizziness, nausea, vomiting, abdominal pain, diarrhea, and cough. Contraindications of PPIs include hypersensitivity to PPIs and the drug rilpivirine, an HIV medication.
Table 31.7 is a drug prototype table for PPIs featuring omeprazole. It lists drug class, mechanism of action, adult dosage, indications, therapeutic effects, drug and food interactions, adverse effects, and contraindications.
|
Drug Class
Proton pump inhibitor (PPI); antisecretory Mechanism of Action Suppresses gastric acid secretion by inhibiting the H + , K + , ATPase enzyme system (proton pump) |
Drug Dosage
20 mg (delayed-release or disintegrating tablet) orally once daily for 14 days. |
|
Indications
Short-term treatment of peptic ulcer, duodenal, and gastric ulcer diseases H. pylori infection GERD Erosive esophagitis Hypersecretion conditions Uncomplicated heartburn Therapeutic Effects An antiulcer agent that suppresses gastric acid secretion to relieve and promote ulcer healing |
Drug Interactions
Amoxicillin Clarithromycin Diazepam Proguanil Moclobemide Phenytoin Warfarin Food Interactions No significant food interactions |
|
Adverse Effects
Diarrhea Abdominal pain Headache Nausea/vomiting Cough Back pain Dizziness |
Contraindications
Hypersensitivity Rilpivirine |
Clinical Tip
Assess for Worsening GI Symptoms
When assessing a client’s response to medications for hyperacidity and antiulcer treatment, monitor signs and symptoms of GI distress—weight, bowel habits, nausea, vomiting, abdominal pain, bloating, or belching. Follow provider instruction on dietary intake; some GI conditions require increased fiber and fluids, while others may require “bowel rest” that involves smaller meals with soft foods.
Nursing Implications
The nurse should do the following for clients who are taking histamine blockers and proton pump inhibitors:
- Prior to administering, assess the client’s medical history, current drug list, and allergies.
- Educate the client regarding duration of use for these medications being short term, typically 4–8 weeks.
- Teach the client to avoid trigger foods that increase stomach acidity such as spicy foods, fried foods, and caffeine.
- Monitor for respiratory infection and/or pneumonia with PPI administration as these may lead to an overgrowth of bacteria in the upper GI tract that can migrate to the lungs.
- Provide the client with teaching regarding the drug and when to call the health care provider. See below for additional client teaching guidelines.
Client Teaching Guidelines
The client taking a histamine blocker and proton pump inhibitor should:
- Adhere to dosing regimen as prescribed by the health care provider, typically short-term administration of 4–8 weeks.
- Avoid trigger foods such as fast food, fried foods, spicy foods, caffeine, tea, and colas as these may increase stomach acid.
- Reports effects such as cough, fever, and shortness of breath to the health care provider as these may be symptoms of a severe adverse reaction.
The client taking a histamine blocker and proton pump inhibitor should not:
- Use for longer than prescribed.


12.6: Liquid-Liquid Equilibria
12.6.1 Miscibility in binary liquid systems
When two different pure liquids are unable to mix in all proportions, they are said to be partially miscible . When these liquids are placed in contact with one another and allowed to come to thermal, mechanical, and transfer equilibrium, the result is two coexisting liquid mixtures of different compositions.
Liquids are never actually completely immiscible . To take an extreme case, liquid mercury, when equilibrated with water, has some H\(_2\)O dissolved in it, and some mercury dissolves in the water, although the amounts may be too small to measure.
The Gibbs phase rule for a multicomponent system to be described in Sec. 13.1 shows that a two-component, two-phase system at equilibrium has only two independent intensive variables. Thus at a given temperature and pressure, the mole fraction compositions of both phases are fixed; the compositions depend only on the identity of the substances and the temperature and pressure.
Figure 13.5 shows a phase diagram for a typical binary liquid mixture that spontaneously separates into two phases when the temperature is lowered. The thermodynamic conditions for phase separation of this kind were discussed in Sec. 11.1.6. The phase separation is usually the result of positive deviations from Raoult’s law. Typically, when phase separation occurs, one of the substances is polar and the other nonpolar.
12.6.2 Solubility of one liquid in another
Suppose substances A and B are both liquids when pure. In discussing the solubility of liquid B in liquid A, we can treat B as either a solute or as a constituent of a liquid mixture. The difference lies in the choice of the standard state or reference state of B.
We can define the solubility of B in A as the maximum amount of B that can dissolve without phase separation in a given amount of A at the given temperature and pressure. Treating B as a solute, we can express its solubility as the mole fraction of B in the phase at the point of phase separation. The addition of any more B to the system will result in two coexisting liquid phases of fixed composition, one of which will have mole fraction \(x\B\) equal to its solubility.
Experimentally, the solubility of B in A can be determined from the cloud point , the point during titration of A with B at which persistent turbidity is observed.
Consider a system with two coexisting liquid phases \(\pha\) and \(\phb\) containing components A and B. Let \(\pha\) be the A-rich phase and \(\phb\) be the B-rich phase. For example, A could be water and B could be benzene, a hydrophobic substance. Phase \(\pha\) would then be an aqueous phase polluted with a low concentration of dissolved benzene, and phase \(\phb\) would be wet benzene. \(x\B\aph\) would be the solubility of the benzene in water, expressed as a mole fraction.
Below, relations are derived for this kind of system using both choices of standard state or reference state.
Solute standard state
Assume that the two components have low mutual solubilities, so that B has a low mole fraction in phase \(\pha\) and a mole fraction close to 1 in phase \(\phb\). It is then appropriate to treat B as a solute in phase \(\pha\) and as a constituent of a liquid mixture in phase \(\phb\). The value of \(x\B\aph\) is the solubility of liquid B in liquid A.
The equilibrium when two liquid phases are present is B(\(\phb\))\(\arrows\)B(\(\pha\)), and the expression for the thermodynamic equilibrium constant, with the solute standard state based on mole fraction, is \begin{equation} K = \frac{a\xbB\aph}{a\B\bph} = \frac{\G\xbB\aph \g\xbB\aph x\B\aph}{\G\B\bph \g\B\bph x\B\bph} \tag{12.6.1} \end{equation} The solubility of B is then given by \begin{equation} x\B\aph = \frac{\G\B\bph\g\B\bph x\B\bph}{\G\xbB\aph\g\xbB\aph}K \tag{12.6.2} \end{equation} The values of the pressure factors and activity coefficients are all close to \(1\), so that the solubility of B in A is given by \(x\B\aph \approx K\). The temperature dependence of the solubility is given by \begin{equation} \frac{\dif\ln x\B\aph}{\dif T} \approx \frac{\dif\ln K}{\dif T} = \frac{\Delsub{sol,B}H\st}{RT^2} \tag{12.6.3} \end{equation} where \(\Delsub{sol,B}H\st\) is the molar enthalpy change for the transfer at pressure \(p\st\) of pure liquid solute to the solution at infinite dilution.
H\(_2\)O and n -butylbenzene are two liquids with very small mutual solubilities. Figure 12.8 shows that the solubility of n -butylbenzene in water exhibits a minimum at about \(12\units{\(\degC\)}\). Equation 12.6.3 allows us to deduce from this behavior that \(\Delsub{sol,B}H\st\) is negative below this temperature, and positive above.
Pure-liquid reference state
The condition for transfer equilibrium of component B is \(\mu\B\aph=\mu\B\bph\). If we use a pure-liquid reference state for B in both phases, this condition becomes \begin{equation} \mu\B^* + RT\ln(\g\B\aph x\B\aph) = \mu\B^* + RT\ln(\g\B\bph x\B\bph) \tag{12.6.4} \end{equation} This results in the following relation between the compositions and activity coefficients: \begin{equation} \g\B\aph x\B\aph = \g\B\bph x\B\bph \tag{12.6.5} \end{equation}
As before, we assume the two components have low mutual solubilities, so that the B-rich phase is almost pure liquid B. Then \(x\B\bph\) is only slightly less than \(1\), \(\g\B\bph\) is close to \(1\), and Eq. 12.6.5 becomes \(x\B\aph \approx 1/\g\B\aph\). Since \(x\B\aph\) is much less than \(1\), \(\g\B\aph\) must be much greater than \(1\).
In environmental chemistry it is common to use a pure-liquid reference state for a nonpolar liquid solute that has very low solubility in water, so that the aqueous solution is essentially at infinite dilution. Let the nonpolar solute be component B, and let the aqueous phase that is equilibrated with liquid B be phase \(\pha\). The activity coefficient \(\g\B\aph\) is then a limiting activity coefficient or activity coefficient at infinite dilution . As explained above, the aqueous solubility of B in this case is given by \(x\B\aph \approx 1/\g\B\aph\), and \(\g\B\aph\) is much greater than \(1\).
We can also relate the solubility of B to its Henry’s law constant \(\kHB\aph\). Suppose the two liquid phases are equilibrated not only with one another but also with a gas phase. Since B is equilibrated between phase \(\pha\) and the gas, we have \(\g\xbB\aph=\fug\B/\kHB\aph x\B\aph\) (Table 9.4). From the equilibration of B between phase \(\phb\) and the gas, we also have \(\g\B\bph=\fug\B/x\B\bph \fug\B^*\). By eliminating the fugacity \(\fug\B\) from these relations, we obtain the general relation \begin{equation} x\B\aph = \frac{\g\B\bph x\B\bph \fug\B^*}{\g\xbB\aph \kHB\aph} \tag{12.6.6} \end{equation} If we assume as before that the activity coefficients and \(x\B\bph\) are close to 1, and that the gas phase behaves ideally, the solubility of B is given by \(x\B\aph \approx p\B^*/\kHB\aph\), where \(p\B^*\) is the vapor pressure of the pure solute.
12.6.3 Solute distribution between two partially-miscible solvents
Consider a two-component system of two equilibrated liquid phases, \(\pha\) and \(\phb\). If we add a small quantity of a third component, C, it will distribute itself between the two phases. It is appropriate to treat C as a solute in both phases. The thermodynamic equilibrium constant for the equilibrium \(\tx{C}(\phb) \arrows \tx{C}(\pha)\), with solute standard states based on mole fraction, is \begin{equation} K = \frac{a\xbC\aph}{a\xbC\bph} = \frac{\G\xbC\aph \g\xbC\aph x\C\aph}{\G\xbC\bph \g\xbC\bph x\C\bph} \tag{12.6.7} \end{equation}
We define \(K'\) as the ratio of the mole fractions of C in the two phases at equilibrium: \begin{equation} K' \defn \frac{x\C\aph}{x\C\bph} = \frac{\G\xbC\bph \g\xbC\bph}{\G\xbC\aph \g\xbC\aph}K \tag{12.6.8} \end{equation} At a fixed \(T\) and \(p\), the pressure factors and equilibrium constant are constants. If \(x\C\) is low enough in both phases for \(\g\xbC\aph\) and \(\g\xbC\bph\) to be close to unity, \(K'\) becomes a constant for the given \(T\) and \(p\). The constancy of \(K'\) over a range of dilute composition is the Nernst distribution law .
Since solute molality and concentration are proportional to mole fraction in dilute solutions, the ratios \(m\C\aph/m\C\bph\) and \(c\C\aph/c\C\bph\) also approach constant values at a given \(T\) and \(p\). The ratio of concentrations is called the partition coefficient or distribution coefficient .
In the limit of infinite dilution of C, the two phases have the compositions that exist when only components A and B are present. As C is added and \(x\C\aph\) and \(x\C\bph\) increase beyond the region of dilute solution behavior, the ratios \(x\B\aph/x\A\aph\) and \(x\B\bph/x\A\bph\) may change. Continued addition of C may increase the mutual solubilities of A and B, resulting, when enough C has been added, in a single liquid phase containing all three components. It is easier to understand this behavior with the help of a ternary phase diagram such as Fig. 13.17.


3.1: Information Disorder, Truth, and Trust
“We tend to think that we have rational relationships to information, but we don’t. We have emotional relationships to information , which is why the most effective disinformation draws on our underlying fears and worldviews….We’re less likely to be critical of information that reinforces our worldview or taps into our deep-seated emotional responses” (Wardle, qtd. in Vongkiatkajorn; emphasis added).
Background
In an information environment shaped by pervasive algorithms, the attention economy, engagement, and polarization, how do we determine truth? How do we know which sources of information to trust? These questions are becoming increasingly difficult to answer, and even more so as “disinformation that is designed to provoke an emotional reaction can flourish in these spaces” (Wardle).
Indeed, in 2016, Oxford Dictionaries selected post-truth as the Word of the Year, defining this as: “relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief.”
Trust
A 2020 study from Project Information Literacy confirms that the way information is delivered today—with opinion and propaganda mingled with traditional news sources, and with algorithms highlighting sources based on engagement rather than quality—has left many college students concerned about the trustworthiness of online content. Students reported that it was difficult to know where to place their trust when credible sources are buried by a deluge of poorer-quality content and misinformation. One student noted that “it’s not that we’re lacking credible information. It’s that we’re drowning in like a sea of all these different points out there” (Head et al. 20).
“This is happening at a time when falsehoods proliferate and trust in truth-seeking institutions is being undermined. Even the very existence of truth itself has come into question….People no longer know what to believe or on what grounds we can determine what is true” (Head et al. 11, 36).
Essential Definitions
First, it is important to establish a shared vocabulary and terminology so that we can better understand and discuss these concepts. Claire Wardle, a world-renowned expert in this field, has used “information disorder” as an umbrella term for the various types of false, misleading, manipulated, or deceptive information we have seen flourish in recent years. She also created an essential glossary for information disorder , with definitions for related words and phrases. For example, you will find helpful definitions for terms like algorithm, bots, data mining, deepfakes, doxing, sock puppet, and trolling.
The graphic below illustrates the scale and range of intent behind false information, from unintentionally inaccurate to deliberately deceptive and harmful. For a much more detailed explanation of each form of information disorder, from “satire” to “fabricated content” to “false context,” see
First Draft’s Essential Guide to Understanding Information Disorder.
Sources
“First Draft’s Essential Guide to Understanding Information Disorder ” by Claire Wardle is licensed under CC BY-NC-ND 4.0
Head, Alison J., Barbara Fister, and Margy MacMillan. “ Information Literacy in the Age of Algorithms .” Project Information Literacy , 15 Jan. 2020. Licensed under CC BY-NC-SA 4.0
Image: “ 3 Types of Information Disorder ” graphic by Claire Wardle & Hossein Derakshan is licensed under CC BY-NC-ND 3.0
Image: “Cognition and Emotion” by ElisaRiva on Pixabay
Image: “ Line Mind ” by ElisaRiva on Pixabay
“ Oxford Word of the Year 2016 .” Oxford Languages , Oxford University Press.
Vongkiatkajorn, Kanyakrit. “ Here’s How You Can Fight Back Against Disinformation .” Mother Jones , 9. Aug. 2018.
Wardle, Claire. “ Information Disorder, Part 1: The Essential Glossary .” First Draft , 9 July 2018.


13.17: Introduction to Store Layout
What you’ll learn to do: Explain the value of a thoughtful store layout
A retailer measures so many things: the average ticket sale for each customer that comes through, the sales per square foot of the store, the penetration of particular product brands, and more. But one thing matters more than any other—customer foot traffic. None of those other metrics matter if you can’t get a customer in the door.
In the last section, we talked about the different kinds of store layouts and the products that are best displayed in them. Now we’re going to talk about traffic flow in a store, how ignoring our four customer behaviors can make or break a sale. A happy, relaxed customer who’s engaged in the shopping experience will spend more, and a confused, disoriented customer will leave.
Contributors and Attributions
- Introduction to Store Layout. Authored by : Freedom Learning Group. Provided by : Lumen Learning. License : CC BY: Attribution


19: The Postmodern World
Introduction
With the many manifestos written in the early 1900s and the technological innovations arriving after WW II, the modern age was embraced allowing for more leisure time, and would ultimately be a time of progress, peace, prosperity, and happiness. The realities of the Modern Movement did not fulfill those high expectations, and art soon moved to counter and criticize the modern with the emergence of Pop Art and overall cynicism. Postmodern art allows the space for critical reflections on modern life as well as creating art from multiple periods. Postmodern artists can pull from the classical past, the Renaissance, world art, and the modern world to create art in a wide range of media. The visual art produced in this period still functions just as art has functioned for thousands of years - it moves us, its uses are many and varied including propaganda, visual delight, to protest, to inform, to educate, and for the fun of it.
Vanna Venturi House, Chestnut Hill, Philadelphia 1962 Robert Venturi
https://video.pbsnc.org/video/geoffrey-baer-tours-9-vanna-venturi-house-web-exclusive/
SITE design for Best Products, Towson, Maryland circa. 1978
https://www.moma.org/documents/moma_catalogue_1781_300297029.pdf
https://failedarchitecture.com/the-ironic-loss-of-the-postmodern-best-store-facades/
550 Madison Avenue, Philip Johnson John Burgee
https://550madison.com/design/
Neue Staatsgalerie, Stuttgart, 1977-83 James Stirling
https://www.youtube.com/watch?v=uzE5X2kVuog
Centre National d'Art et Culture Georges Pompidou, Paris 1971-77 Richard Rogers and Renzo Piano
https://www.youtube.com/watch?v=9DOVlROG-lY
https://www.youtube.com/watch?v=LC2NpJQCVHQ
Hong Kong and Shanghai Bank, Hong Kong, China 1979-86 Norman Foster
https://www.youtube.com/watch?v=5Yp7tIbz6D8
Kansai Airport, 1988 Renzo Piano Building Workshop
https://www.youtube.com/watch?v=va4j-bcmuPI
Guggenheim Museum, Bilbao, Spain 1992-97 Frank Lloyd Wright
https://www.youtube.com/watch?v=XrVCVJOcvzs
Vietnam Memorial, 1982 Maya Lin
https://www.youtube.com/watch?v=wuxjTxxQUTs


11.4: When should students be rewarded or punished?
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By Wendy Belgrave
Learning Objectives
- To understand what positive reinforcement means
- Understand there can be drawbacks to any method
- To learn alternative ways of punishment
Introduction
"Great job on figuring out that problem! Way to analyze the data Sarah. And you Nathan! I want you to write me a 500 word essay on why it is important to pay attention and be quiet while class is in session. I'm tired of having to talk to you about this!" Does this seem fair to you? In an ideal world the students would walk into a classroom, and their soft murmurs would come to a halt once the bell rang. They would all take out their paper and pencils, take notes, raise their hand if they had a question or answer, and smile during the entire class period. But this is not fantasy land and we have children coming into our classrooms with all sorts of personalities and issues. A teacher might find it easy to praise their students when they do something good, but what if the students are having a “bad day”? Can you really catch more flies with honey than with vinegar?
Reinforcing A Desired Behavior
Note
“You can win people to your side more easily by gentle persuasion and flattery, than by hostile confrontation (Hirch 1988 p. 49),"
Growing up, receiving a sticker on a gold star at the end of the day was the ultimate feeling for me. The sticker meant a job well done throughout the day. I didn’t know it at the time but that was positive reinforcement at its best. The concept definition of positive reinforcement, according to the Centre of Psychology , occurs when 3 conditions have been met (Grant 1996).
- A consequence is presented dependent on a behavior.
- The behavior becomes more likely to occur.
- The behavior becomes more likely to occur because and only because the consequence is presented dependent on the behavior.
In my observations I have witnessed teachers praise their students. You do not hear the student say how this makes them feel, but you will see their demeanor change when a student is given accolades in front of his or her peers. This provokes a willingness to chime in more often regardless of right or wrong answers. A student named Lee Ray was recognized for his risk taking. His teacher wrote a summary of him saying, "He answers all the questions, correct or not (Lashaway-Bokina 2000 p. 225)." Positive feedback and recognition build self esteem and confidence.
Giving a student a “good job” for a correct answer is always good, but the learning of subject matter is not the only thing that deserves recognition. Rewarding desired behavior is easier than you may think. For instance, you are doing a class project that requires cutting pieces of paper, at the end of the project you notice a student picking up pieces of paper that fell off the desk and throwing them in the trash. This is a perfect opportunity to acknowledge a thoughtful gesture. This in turn tells the other students to do the same without you having to request it. This is much more effective than reminding the students that you are not their parent and won’t pick up after them. Acknowledging good attendance, a pat on the back for team work, and even recognizing special achievements even if they are not related to the class are great ways to build self esteem. Just as important, the recognition of improved behavior or grades is also a great confidence builder. Sending a post card home to the child’s parents is a great way to reinforce positive behavior.
Note
“You must systematically strengthen the behavior you want while systematically weakening the competing behaviors that you do not want. A discipline program, for example, should not only eliminate problem behavior, but it should also systematically build the positive behaviors that you want to replace the problems (Fred Jones).
When Rewarding By Incentives Goes Bad
Some teachers choose to pass out candy or give special privileges for good behavior or for doing certain tasks, but what if there is not an actual reward other than a “thank you”? Student Awards, Rewards, and Recognition says that you mustn’t use rewards as incentives because it sends this message, “if you do this, then you get this.” This may seem too much like bribing. Bloggers on An Unschooling Life , are not fans of the rewards for learning. They believe that the reward for studying is learning. One of the bloggers who is a homeschooling parent said, “If someone had to bribe me to do something, my first thought would be "It must be unpleasant if you have to bribe me to do it." She continued on to say that her daughter would only read if she was given candy while in school.
Peter Callaghan, a writer for The News Tribune , agrees with the home schooling parent about the damage that incentives create. He mentions a school in Washington that was giving a five week course to better scores on reading, writing, and mathematics for an upcoming standardized test. A $79 free IPod Shuffle was offered to every student that signed up. Only 80 failing students had signed up for the test before the incentive was given. The incentive was enough to fill 270 additional slots. “Kids who goof off shouldn’t receive gifts while kids who try hard get nothing extra. Kids shouldn’t be bribed to try to learn something (Callaghan 207).”
Punishment As An Incentive
It would be easier to teach a classroom full of children if there were no children misbehaving. According to Student Teacher Advocate , one third of new teachers leave the teaching field within the first 3 years. The teachers questioned said that they spend an overwhelming amount of time doing other tasks (disciplining included), beyond actual instruction. Forty percent of those teachers surveyed said that they spend more time than expected on disciplining (Miller, Higgins).
Teachers sometimes find punishment to be effective as a classroom behavior management tool, especially as a short term solution. Because punishment tends to rapidly stop problem behaviors, the teacher in turn is positively reinforced for using it (What Every Teacher Should Know About Punishment 2008). Teachers may be tempted to use this technique over and over because of its quick response, but this very sort of punishment can have side effects. Students who are generally punished in this way can overtime develop negative attitudes toward school, can develop an uncomfortable relationship with their teachers, and perhaps feel apprehensive about participating in class activities (What Every Teacher Should Know About Punishment 2008). Discipline and punishment are important parts of rearing children not only at home but in school settings as well.
When people use the word “punish”, it is usually used to describe a negative consequences for a violation. In some schools around the United States punishment can mean physical punishment. Corporal punishment is still allowed in 21 out of 50 states, but is only practiced in 4 of those states; Alabama, Arkansas, Mississippi and Tennessee (Farrell). According to C. Farrell, a writer for School Corporal Punishment , paddlings were given in the classroom or right outside the door, but then only the principle had to do the paddling or it was done in front of his or her presence in a private room. Some of the people I spoke to remember being paddled or being hit on the palms with a ruler for horse playing. Educators must be careful and administer punishment with care, especially if it comes in the form of corporal punishment. "Punishments are an expression of violence of the more powerful adult against the weaker child (Cerney 2008 p.51)."
Note
“According to estimates from the federal Department of Education (Office of Civil Rights), there were about 272,000 paddlings of students in the 2004-05 school year -- down from 457,754 only eight years previously. This shows that the rapid decline of the 1980s and early 1990s, which had leveled off by the middle of the 1990s, has now resumed. Total paddlings were equivalent to only 0.6% of the total US school population (Farrell)."
Alternative Ways Of Punishment
Punishment can take on many forms; it can be a reprimand, or a type of punishment known as response cost. Response cost means that a student can have rewards, or privileges taken away when he or she demonstrates problem behavior even if it is only momentarily (What Every Teacher Should Know About Punishment 2008). An example would be that a student on time-out would not be able to join his or her classmates when it is time for playtime until their time-out was over.
Disciplining does not necessarily mean having the child sit in the corner with a dunce hat on, getting paddled, whacked on the hands, or writing sentences. Experienced teachers will say that remaining calm can diffuse an angry disposition more effectively than responding in an equal tone. One of the teachers that I interviewed, Kristin Gorsuch, a high school math teacher from Isle of Wight County, said that when she has a continually disruptive student, she simply asks them to step outside for a minute until she can go outside and discuss in private what she expects. The point is not to intimidate or belittle them in front of their peers.
You will see and hear what other teachers believe is a good way of “punishing” a student without it being demeaning or embarrassing. Visit this web site for the videos under “What Would You Do?” www.nea.org/classmanagement/discipline.html
Conclusion
Time changes everything. The material taught in schools, the thoughts on child creativity, and classroom management have all been revised over time. The question as to what is a better way to develop productive adults has perplexed people for ages. Should we pat our children on the back for a mediocre job and hope that next time they do better, or should we whoop them into shape, tell them what we expect and show no mercy since the “real world” won’t show them any? As educators we need to build up our children and young adults, evaluate what the problem really is, if any and make a decision based on each child. There is no cookie cutter solution.
Exercise \(\PageIndex{1}\)
1. Mary Beth has been put on time out right before craft time. You tell her that when all the other children are getting their crafts out, she has to wait out her 3 minute time out until she can go to collect her crafts. What is this an example of?
a. Association
b. Negative collection
c. Pay back
d. Response cost
2. You have just passed back homework papers and one of your students was extremely unhappy with his grade. He begins to speak very loudly and disrespectfully and becomes confrontational. What is the best way to respond to his actions?'
a. Ask him to step outside for a minute
b. Call him a name
c. Respond equally as angry
d. Try to restrain him
3. What is an example of positive reinforcement?
a. Invite the police to the school to scare the little children
b. Keep the child after school up against the wall in chair position
c. Stitch a compliment onto a child’s shirt
d. When a child puts back his or her toys on the shelf, say thank you and good job
4. Which one is not positive recognition?
a. Recognize that Joel has won 1st place in the Science Fair
b. Recognize that Joel has perfect attendance
c. Recognize that Joel has successfully completed a reading assignment
d. Recognize that Joel is falling asleep in class
5. Some parents to home schoolers say that they do not like the rewards incentive because...
a. They do not like their children eating candy.
b. They do not want their children to only do the work when there is an incentive.
c. The schools will spend too much money.
d. They want to give the incentives
- Answer
-
1. D
2. A
3. D
4. D
5. B
References
1. An Unschooling Life: Rewarding (Bribing) Children To Learn. (2008, January 24). Retrieved Sep. 17, 2008, from http://anunschoolinglife.blogspot.com/2006/06/day-one-hundred.html .
2. Callaghan, P. (2007, July 26). Don’t they know learning is its own reward? | TheNewsTribune.com | Tacoma, WA. Retrieved Sep. 17, 2008, from www.thenewstribune.com/news/columnists/callaghan/story/118809.html.
3. Cerny, J. (2008). Spare the Rod Spoil the Child. New Presence, 11(2), 51,52. Retrieved Sep. 17, 2008, from the Academic Search Complete database.
4. Classroom Management. (n.d.). Retrieved Sep. 17, 2008, from www.nea.org/classmanagement/discipline.html.
5. Farrell, C. (n.d.). CORPORAL PUNISHMENT IN AMERICAN SCHOOLS. Retrieved Sep. 17, 2008, from http://www.corpun.com/counuss.htm .
6. Farrell, C. (n.d.). SCHOOL CORPORAL PUNISHMENT: Video clips 2008: United States—real-life paddling (Arkansas high school). Retrieved Sep. 17, 2008, from http://www.corpun.com/viduss02.htm .
7. Flanery, M. (n.d.). NEA: The 'D' Word. Retrieved Sep. 21, 2008, from www.nea.org/neatoday/0509/coverstory.html.
8. Goresuch, Kristin. "Reward or Punishment." Personal interview. 19 Sept. 2008.
9. Grant, L. (1996, January 12). Positive Reinforcement Tutorial. Retrieved Sep. 17, 2008, from http://psych.athabascau.ca/html/prtut/reinpair.htm .
10. Hirch Jr, E., Kett, J., & Trefil , J. (1988). The Dictionary of Cultural Literacy. Boston: Houghton Mifflin Co..
11. Jones, F. (n.d.). Positive Classroom Discipline - Chapter 18, Discipline Management as an Integrated System. Retrieved Sep. 17, 2008, from www.fredjones.com/Positive_Discipline/Discipline_Ch18.html.
12. Lashaway-Bokina, , N. (2000). Recognizing and Nurturing Intrinsic Motivation. A Cautionary Tale, 22(4), 225. Retrieved Sep. 17, 2008, from the Academic Search Complete database.
13. Miller, M., & Higgins, B. (n.d.).  Retrieved Sep. 21, 2008, from http://www.kdp.org/publications/studentteacheradvocate/dontbecome.htm .
14. Student Awards, Rewards and Recognition. (2008, April 18). Retrieved Sep. 21, 2008, from www.baudville.com/articles.asp?a=32.
15. What Every Teacher Should Know About Punishment. (n.d.). Retrieved Sep. 17, 2008, from www.interventioncentral.org/htmdocs/interventions/behavior/punishguidelines.php.


2.4.1: Measures of the Location of the Data (Exercises)
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Exercise 2.4.10
Listed are 29 ages for Academy Award winning best actors in order from smallest to largest.
18; 21; 22; 25; 26; 27; 29; 30; 31; 33; 36; 37; 41; 42; 47; 52; 55; 57; 58; 62; 64; 67; 69; 71; 72; 73; 74; 76; 77
- Find the 40 th percentile.
- Find the 78 th percentile.
Answer
- The 40 th percentile is 37 years.
- The 78 th percentile is 70 years.
Exercise 2.4.11
Listed are 32 ages for Academy Award winning best actors in order from smallest to largest.
18; 18; 21; 22; 25; 26; 27; 29; 30; 31; 31; 33; 36; 37; 37; 41; 42; 47; 52; 55; 57; 58; 62; 64; 67; 69; 71; 72; 73; 74; 76; 77
- Find the percentile of 37.
- Find the percentile of 72.
Exercise 2.4.12
Jesse was ranked 37 th in his graduating class of 180 students. At what percentile is Jesse’s ranking?
Answer
Jesse graduated 37 th out of a class of 180 students. There are 180 – 37 = 143 students ranked below Jesse. There is one rank of 37.
\(x = 143\) and \(y = 1\). \(\dfrac{x + 0.5y}{n}(100) = \dfrac{143 + 0.5(1)}{180}(100) = 79.72\). Jesse’s rank of 37 puts him at the 80 th percentile.
Exercise 2.4.13
- For runners in a race, a low time means a faster run. The winners in a race have the shortest running times. Is it more desirable to have a finish time with a high or a low percentile when running a race?
- The 20 th percentile of run times in a particular race is 5.2 minutes. Write a sentence interpreting the 20 th percentile in the context of the situation.
- A bicyclist in the 90 th percentile of a bicycle race completed the race in 1 hour and 12 minutes. Is he among the fastest or slowest cyclists in the race? Write a sentence interpreting the 90 th percentile in the context of the situation.
Exercise 2.4.14
- For runners in a race, a higher speed means a faster run. Is it more desirable to have a speed with a high or a low percentile when running a race?
- The 40 th percentile of speeds in a particular race is 7.5 miles per hour. Write a sentence interpreting the 40 th percentile in the context of the situation.
Answer
- For runners in a race it is more desirable to have a high percentile for speed. A high percentile means a higher speed which is faster.
- 40% of runners ran at speeds of 7.5 miles per hour or less (slower). 60% of runners ran at speeds of 7.5 miles per hour or more (faster).
Exercise 2.4.15
On an exam, would it be more desirable to earn a grade with a high or low percentile? Explain.
Exercise 2.4.16
Mina is waiting in line at the Department of Motor Vehicles (DMV). Her wait time of 32 minutes is the 85 th percentile of wait times. Is that good or bad? Write a sentence interpreting the 85 th percentile in the context of this situation.
Answer
When waiting in line at the DMV, the 85 th percentile would be a long wait time compared to the other people waiting. 85% of people had shorter wait times than Mina. In this context, Mina would prefer a wait time corresponding to a lower percentile. 85% of people at the DMV waited 32 minutes or less. 15% of people at the DMV waited 32 minutes or longer.
Exercise 2.4.17
In a survey collecting data about the salaries earned by recent college graduates, Li found that her salary was in the 78 th percentile. Should Li be pleased or upset by this result? Explain.
Exercise 2.4.18
In a study collecting data about the repair costs of damage to automobiles in a certain type of crash tests, a certain model of car had $1,700 in damage and was in the 90 th percentile. Should the manufacturer and the consumer be pleased or upset by this result? Explain and write a sentence that interprets the 90 th percentile in the context of this problem.
Answer
The manufacturer and the consumer would be upset. This is a large repair cost for the damages, compared to the other cars in the sample. INTERPRETATION: 90% of the crash tested cars had damage repair costs of $1700 or less; only 10% had damage repair costs of $1700 or more.
Exercise 2.4.19
The University of California has two criteria used to set admission standards for freshman to be admitted to a college in the UC system:
- Students' GPAs and scores on standardized tests (SATs and ACTs) are entered into a formula that calculates an "admissions index" score. The admissions index score is used to set eligibility standards intended to meet the goal of admitting the top 12% of high school students in the state. In this context, what percentile does the top 12% represent?
- Students whose GPAs are at or above the 96 th percentile of all students at their high school are eligible (called eligible in the local context), even if they are not in the top 12% of all students in the state. What percentage of students from each high school are "eligible in the local context"?
Exercise 2.4.20
Suppose that you are buying a house. You and your realtor have determined that the most expensive house you can afford is the 34 th percentile. The 34 th percentile of housing prices is $240,000 in the town you want to move to. In this town, can you afford 34% of the houses or 66% of the houses?
Answer
You can afford 34% of houses. 66% of the houses are too expensive for your budget. INTERPRETATION: 34% of houses cost $240,000 or less. 66% of houses cost $240,000 or more.
Use Exercise to calculate the following values:
Exercise 2.4.21
First quartile = _______
Exercise 2.4.22
Second quartile = median = 50 th percentile = _______
Answer
4
Exercise 2.4.23
Third quartile = _______
Exercise 2.4.24
Interquartile range ( IQR ) = _____ – _____ = _____
Answer
\(6 - 4 = 2\)
Exercise 2.4.25
10 th percentile = _______
Exercise 2.4.26
70 th percentile = _______
Answer
6


7.9: The Analysis of Liquid Crystal Phases using Polarized Optical Microscopy
Liquid Crystal Phases
Liquid crystals are a state of matter that has the properties between solid crystal and common liquid. There are basically three different types of liquid crystal phases:
- Thermotropic liquid crystal phases are dependent on temperature.
- Lyotropic liquid crystal phases are dependent on temperature and the concentration of LCs in the solvent.
- Metallotropic LCs are composed of organic and inorganic molecules, and the phase transition not only depend on temperature and concentration, but also depend on the ratio between organic and inorganic molecules.
Thermotropic LCs are the most widely used one, which can be divided into five categories:
- Nematic phase in which rod-shaped molecules have no positional order, but they self-align to have long-range directional order with their long axes roughly parallel (Figure \(\PageIndex{1}\)a).
- Smactic phase where the molecules are positionally ordered along one direction in well-defined layers oriented either along the layer normal (smectic A) or tilted away from the layer normal (smectic C), see Figure \(\PageIndex{1}\)b.
- Chiral phase which exhibits a twisting of the molecules perpendicular to the director, with the molecular axis parallel to the director Figure \(\PageIndex{1}\) c.
- Blue phase having a regular three-dimensional cubic structure of defects with lattice periods of several hundred nanometers, and thus they exhibit selective Bragg reflections in the wavelength range of light Figure \(\PageIndex{2}\).
- Discotic phase in which disk-shaped LC molecules can orient themselves in a layer-like fashion Figure \(\PageIndex{3}\).
Thermotropic LCs are very sensitive to temperature. If the temperature is too high, thermal motion will destroy the ordering of LCs, and push it into a liquid phase. If the temperature is too low, thermal motion is hard to perform, so the material will become crystal phase.
The existence of liquid crystal phase can be detected by using polarized optical microscopy, since liquid crystal phase exhibits its unique texture under microscopy. The contrasting areas in the texture correspond to domains where LCs are oriented towards different directions.
Polarized Optical Microscopy
Polarized optical microscopy is typically used to detect the existence of liquid crystal phases in a solution.The principle of this is corresponding to the polarization of light. A polarizer is a filter that only permits the light oriented in a specific direction with its polarizing direction to pass through. There are two polarizers in a polarizing optical microscope (POM) (Figure \(\PageIndex{4}\)) and they are designed to be oriented at right angle to each other, which is termed as cross polar. The fundamental of cross polar is illustrated in Figure \(\PageIndex{5}\), the polarizing direction of the first polarizer is oriented vertically to the incident beam, so only the waves with vertical direction can pass through it. The passed wave is subsequently blocked by the second polarizer, since this polarizer is oriented horizontally to the incident wave.
Theory of Birefringence
Birefringent or doubly-refracting sample has a unique property that it can produce two individual wave components while one wave passes through it, those two components are termed as ordinary and extraordinary waves. Figure \(\PageIndex{6}\) is an illustration of a typical construction of Nicol polarizing prism, as we can see, the non-plarized white light are splitted into two ray as it passes through the prism. The one travels out of the prism is called ordinary ray, and the other one is called extraordinary ray. So if we have a birefringent specimen located between the polarizer and analyzer, the initial light will be separated into two waves when it passes though the specimen. After exiting the specimen, the light components become out of phase, but are recombined with constructive and destructive interference when they pass through the analyzer. Now the combined wave will have elliptically or circularly polarized light wave, see Figure \(\PageIndex{7}\), image contrast arises from the interaction of plane-polarized light with a birefringent specimen so some amount of wave will pass through the analyzer and give a bright domain on the specimen.
Liquid Crystal Display
The most common application of LCs are in liquid crystals displays (LCD). Figure \(\PageIndex{8}\) is a simple demonstration of how LCD works in digit calculators. There are two crossed polarizers in this system, and liquid crystal (cholesteric spiral pattern) sandwich with positive and negative charging is located between these two polarizers. When the liquid crystal is charged, waves can pass through without changing orientations. When the liquid crystal is out of charge, waves will be rotated 90° as it passes through LCs so it can pass through the second polarizer. There are seven separately charged electrodes in the LCD, so the LCD can exhibit different numbers from 0 to 9 by adjusting the electrodes. For example, when the upper right and lower left electrodes are charged, we can get 2 on the display.
Microscope Images of Liquid Crystal Phase
The first order retardation plate is frequently utilized to determine the optical sign of a birefringent specimen in polarized light microscopy. The optical sign includes positive and negative. If the ordinary wavefront is faster than the extraordinary wavefront (see Figure \(\PageIndex{9}\) a). When a first order retardation plate is added, the structure of the cell become all apparent compared with the one without retardation plate, Figure \(\PageIndex{9}\) b).
Images of Liquid Crystal Phases
Figure \(\PageIndex{10}\) shows the images of liquid crystal phases from different specimens. First order retardation plates are utilized in all of these images. Apparent contrasts are detected here in the image which corresponds to the existence of liquid crystal phase within the specimen.
The Effect of Rotation of the Polarizer
The effect of the angle between horizontal direction and polarizer transmission axis on the appearance of liquid crystal phase may be analyzed. In Figure \(\PageIndex{11}\) is show images of an ascorbic acid (Figure \(\PageIndex{12}\)) sample under cross polar mode. When the polarizer rotates from 0° to 90°, big variations on the shape of bright domains and domain colors appear due to the change of wave vibrating directions. By rotating the polarizer, we can have a comprehensive understanding of the overall texture.


2.7: Key Words and Terms
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- Ying Liu
- City College of San Francisco
| anaphase | G 2 phase | mTOR signaling |
| apoptosis | Guardian of the Genome | necrosis |
| ATM kinase | immunotherapy | oncogenic viruses |
| benign tumors | intergrin | p14ARF |
| cancer cells | interphase | p21 |
| CDKs | invasive tumors | p53 |
| cell cycle | LFS | |
| cell cycle checkpoints | Li-Fraumeni Syndrome | PD-L1 |
| chemotherapy | M checkpoint | programmed cell death |
| Chk2 | M phase of the cell cycle | prophase |
| colchicine | malignant tumors | protein phosphorlyation |
| cyclin | MAPK | proteasome |
| cyclin level in cell cycle | maturation | radiation therapy |
| cytokinesis | maturation promoting | S phase |
| dideoxyNTP | Mdm2 | signal transduction |
| elephant p53 genes | metaphase | SV40 |
| FAK | metastasis | T antigens |
| G 0 of the cell cycle | mitosis | taxol |
| G 1 checkpoint | mitosis promoting factor | telophase |
| G 1 phase | mitotic phases | tumor suppressor protein |
| G 2 checkpoint | MPF | ubiquitination |


12.2: Gibbs Phase Rule
In chapter 1 , we have already seen that the number of independent variables required to describe an ideal gas is two. This number was derived by counting the total number of variables \((3: P,\overline{V},T)\), and reduce it by one because the ideal gas law constrains the value of one of them, once the other two are fixed. For a generic system potentially containing more than one chemical substance in several different phases, however, the number of independent variables can be different than two. For a system composed of \(c\) components (chemical substances) and \(p\) phases, the number of independent variables, \(f\), is given by the Gibbs phase rule:
\[ f=c-p+2. \label{12.2.1} \]
The Gibbs phase rule derives from the fact that different phases are in equilibrium with each other at some conditions, resulting in the reduction of the number of independent variables at those conditions. More rigorously, when two phases are in thermodynamic equilibrium, their chemical potentials are equal (see Equation 12.1.4 ). For each equality, the number of independent variables—also called the number of degrees of freedom —is reduced by one. For example, the chemical potentials of the liquid and its vapor depend on both \(T\) and \(P\). But when these phases are in equilibrium with each other, their chemical potentials must be equal. If either the pressure or the temperature is fixed, the other variable will be uniquely determined by the equality relation. In other terms, when a liquid is in equilibrium with its vapor at a given pressure, the temperature is determined by the fact that the chemical potentials of the two phases is the same, and is denoted as the boiling temperature \(T_{\text{b}}\). Similarly, at a given temperature, the pressure of the vapor is uniquely determined by the same equality relation and is denoted as the vapor pressure, \(P^*\).
The Gibbs phase rule is obtained considering that the number of independent variables is given by the total number of variables minus the constraints. The total number of variables is given by temperature, pressure, plus all the variables required to describe each of the phases. The composition of each phase is determined by \((c-1)\) variables.\(^1\) The number of constraints is determined by the number of possible equilibrium relations, which is \(c(p-1)\) since the chemical potential of each component must be equal in all phases. The number of degrees of freedom \(f\) is then given by
\[\begin{align*} f &=(c-1)p+2-c(p-1) \\[4pt] &=c-p+2 \end{align*} \]
which is the Gibbs phase rule, as in Equation \ref{12.2.1}.
- For a 1-component system \(c-1=1-1=0\), and no additional variable is required to determine the composition of each phase. For a 2-component system, however, each phase will contain both components, hence \(c-1=2-1=1\) additional variable will be required to describe it–the mole fraction.


6.3: Ethical Dilemmas
Nurses frequently find themselves involved in conflicts during patient care related to opposing values and ethical principles. These conflicts are referred to as ethical dilemmas. An ethical dilemma results from conflict of competing values and requires a decision to be made from equally desirable or undesirable options.
An ethical dilemma can involve conflicting patient’s values, nurse values, health care provider’s values, organizational values, and societal values associated with unique facts of a specific situation. For this reason, it can be challenging to arrive at a clearly superior solution for all stakeholders involved in an ethical dilemma. Nurses may also encounter moral dilemmas where the right course of action is known but the nurse is limited by forces outside their control. See Table 6.3a for an example of ethical dilemmas a nurse may experience in their nursing practice.
| Workplace | Organizational Processes | Client Care |
|---|---|---|
|
|
|
Read more about Ethics Topics and Articles on the ANA website.
According to the American Nurses Association (ANA), a nurse’s ethical competence depends on several factors [1] :
- Continuous appraisal of personal and professional values and how they may impact interpretation of an issue and decision-making
- An awareness of ethical obligations as mandated in the Code of Ethics for Nurses With Interpretive Statements [2]
- Knowledge of ethical principles and their application to ethical decision-making
- Motivation and skills to implement an ethical decision
Nurses and nursing students must have moral courage to address the conflicts involved in ethical dilemmas with “the willingness to speak out and do what is right in the face of forces that would lead us to act in some other way.” [3] See Figure 6.7 [4] for an illustration of nurses’ moral courage.
Nurse leaders and organizations can support moral courage by creating environments where nurses feel safe and supported to speak up. [5] Nurses may experience moral conflict when they are uncertain about what values or principles should be applied to an ethical issue that arises during patient care. Moral conflict can progress to moral distress when the nurse identifies the correct ethical action but feels constrained by competing values of an organization or other individuals. Nurses may also feel moral outrage when witnessing immoral acts or practices they feel powerless to change. For this reason, it is essential for nurses and nursing students to be aware of frameworks for solving ethical dilemmas that consider ethical theories, ethical principles, personal values, societal values, and professionally sanctioned guidelines such as the ANA Nursing Code of Ethics.
Moral injury felt by nurses and other health care workers in response to the COVID-19 pandemic has gained recent public attention. Moral injury refers to the distressing psychological, behavioral, social, and sometimes spiritual aftermath of exposure to events that contradict deeply held moral beliefs and expectations. [6] Health care workers may not have the time or resources to process their feelings of moral injury caused by the pandemic, which can result in burnout. Organizations can assist employees in processing these feelings of moral injury with expanded employee assistance programs or other structured support programs. [7] Read more about self-care strategies to address feelings of burnout in the “ Burnout and Self-Care ” chapter.
Frameworks for Solving Ethical Dilemmas
Systematically working through an ethical dilemma is key to identifying a solution. Many frameworks exist for solving an ethical dilemma, including the nursing process, four-quadrant approach, the MORAL model, and the organization-focused PLUS Ethical Decision-Making model. [8] When nurses use a structured, systematic approach to resolving ethical dilemmas with appropriate data collection, identification and analysis of options, and inclusion of stakeholders, they have met their legal, ethical, and moral responsibilities, even if the outcome is less than ideal.
Nursing Process Model
The nursing process is a structured problem-solving approach that nurses may apply in ethical decision-making to guide data collection and analysis. See Table 6.3b for suggestions on how to use the nursing process model during an ethical dilemma. [9]
| Nursing Process Stage | Considerations |
|---|---|
| Assessment/ Data Collection |
|
| Assessment/ Analysis |
|
| Diagnosis |
|
| Outcome Identification |
|
| Planning |
|
| Implementation |
|
| Evaluation |
|
Four-Quadrant Approach
The four-quadrant approach integrates ethical principles (e.g., beneficence, nonmaleficence, autonomy, and justice) in conjunction with health care indications, individual and family preferences, quality of life, and contextual features. [11] See Table 6.3c for sample questions used during the four-quadrant approach.
|
Health Care Indications
(Beneficence and Nonmaleficence)
|
Individual and Family Preferences
(Respect for Autonomy)
|
|
Quality of Life
(Beneficence, Nonmaleficence, and Respect for Autonomy)
|
Contextual Features
(Justice and Fairness)
|
MORAL Model
The MORAL model is a nurse-generated, decision-making model originating from research on nursing-specific moral dilemmas involving client autonomy, quality of life, distributing resources, and maintaining professional standards. The model provides guidance for nurses to systematically analyze and address real-life ethical dilemmas. The steps in the process may be remembered by using the mnemonic MORAL. See Table 6.3d for a description of each step of the MORAL model. [13] , [14]
| M: Massage the dilemma | Collect data by identifying the interests and perceptions of those involved, defining the dilemma, and describing conflicts. Establish a goal. |
|---|---|
| O: Outline options | Generate several effective alternatives to reach the goal. |
| R: Review criteria and resolve | Identify moral criteria and select the course of action. |
| A: Affirm position and act | Implement action based on knowledge from the previous steps (M-O-R). |
| L: Look back | Evaluate each step and the decision made. |
PLUS Ethical Decision-Making Model
The PLUS Ethical Decision-Making model was created by the Ethics and Compliance Initiative to help organizations empower employees to make ethical decisions in the workplace. This model uses four filters throughout the ethical decision-making process, referred to by the mnemonic PLUS:
- P: Policies, procedures, and guidelines of an organization
- L: Laws and regulations
- U: Universal values and principles of an organization
- S: Self-identification of what is good, right, fair, and equitable [15]
The seven steps of the PLUS Ethical Decision-Making model are as follows [16] :
- Define the problem using PLUS filters
- Seek relevant assistance, guidance, and support
- Identify available alternatives
- Evaluate the alternatives using PLUS to identify their impact
- Make the decision
- Implement the decision
- Evaluate the decision using PLUS filters
- American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. ↵
- American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. American Nurses Association. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/coe-view-only / ↵
- American Nurses Association (ANA). Ethics topics and articles. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/ethics-topics-and-articles/ ↵
- “Moral courage.png” by Meredith Pomietlo for Chippewa Valley Technical College is licensed under CC BY 4.0 ↵
- American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. ↵
- Norman, S. & Maguen, S. (n.d.). Moral injury. PTSD: National Center for PTSD, U.S. Department of Veterans Affairs. https://www.ptsd.va.gov/professional/treat/cooccurring/moral_injury.asp ↵
- Dean, W., Jacobs, B., & Manfredi, R. A. (2020). Moral injury: The invisible epidemic in COVID health care workers. Annals of Emergency Medicine, 76 (4), 385–386. https://doi.org/10.1016/j.annemergmed.2020.05.023 ↵
- American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. ↵
- American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. ↵
- American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. ↵
- American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. ↵
- American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. ↵
- American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. ↵
- Crisham, P. (1985). Moral: How can I do what is right? Nursing Management, 16 (3), 44. https://journals.lww.com/nursingmanagement/citation/1985/03000/moral__how_can_i_do_what_s_right_.6.aspx ↵
- Ethics & Compliance Initiative. (2021). The PLUS Ethical Decision Making Model . https://www.ethics.org/resources/free-toolkit/decision-making-model/ ↵
- Ethics & Compliance Initiative. (2021). The PLUS Ethical Decision Making Model . https://www.ethics.org/resources/free-toolkit/decision-making-model/ ↵