Cuba and China Essay

Democracy, or the power of people, is rather old form of rule. While the word â€Å"democracy† originated in the Ancient Greece in 5th century BC, this form of rule had existed even before this, found in ancient India republics before 6th century BC. However, it was the city-state of Athens in the Ancient Greece that presented this word in the sense which resembles, in some features, the modern vision of democracy. In Athens, people had the right to vote, to take the most important decisions, influencing the political situation of their state. Of course, not all the population could vote – women and children could not vote as well as disabled people. In fact, only one forth or one sixth of the citizens of Athens could vote and participate in a political life of their state. However, it was the first form of democracy and it had many aspects in common with today’s notion of democracy. For example, all the citizens of Athens, poor or rich, powerful or powerless, had the right to vote, they were equal in this right. The democracy, in the form in which it existed in Athens and in the Ancient Greece, was not preserved until our time. Moreover, great changes took place in Europe in 18-19th centuries, in the form of revolutions. The right to vote and to participate in the political life of a state directly is not the main factor characterizing democracy in the modern world. Democracy in the modern sense includes such basic postulates as the basic freedoms: of speech, of expression, of the press, of association et cetera. The democracy in the western world is much more associated with the notion of free market and free trade. However, these preconditions are not exactly true for some countries, for example for China, where free market and free trade can coexist with the lack of democracy, where there are no basic freedoms (for example, the freedom of association – the assembly of Falun Gong in China was violently dispersed by police and banished for practicing in China). Cuba which has made some steps toward the free market economy, opening some part of its economy for the US dollars, does allow the internationally recognized organization of the Red Cross to its prisons, where political prisoners are kept in big numbers. The rule of Communist Party as the only party in the country is observed both in Cuba and in China. And this excludes another characteristic feature of democracy – pluralism, the possibility of many political parties to take part in the political life of the state. Before we proceed to explain the lack of democracy in Cuba and China, it is necessary to understand what democracy means and why China and Cuba should become democratic. In the twentieth century, democracy has gained such popularity that most world rulers describe their rule as democratic. However, most countries were not democratic, and some even became totalitarian. Generally speaking, the term â€Å"democracy† is misused in two ways. First, democracy is expanded into a laundry list that contains almost all kinds of good things. Second, democracy is modified by adding an adjective to the term. Since Western bourgeois democracy is the prototype of modern democracy, modifications are made along two lines. Either rulers characterize their systems not as bourgeois democracies, but as â€Å"people’s democracies,† â€Å"proletarian democracies,† or â€Å"socialist democracies,† or they emphasize local characteristics of their system, such as â€Å"Burmese type of democracy† or â€Å"African type of democracy. † What is democracy? Etymologically, the term means rule by the people. Democracy originated in Athens more than 2,500 years ago, when Cleisthenes allowed all citizens of Attica to preside over the affairs of the city. Athenian democracy took the form of direct democracy. Citizens, which excluded women, slaves, and resident aliens, participated directly in making laws. Moreover, regardless of their properties and talents, rulers were selected not by ballot but by lot. Not surprisingly, virtually all famous Greek scholars were no fans of democracy, regarding tyranny, oligarchy, and democracy as corrupt forms of government. Democracy includes two forms: popular sovereignty and individual liberty. This paper defines democracy in terms of political freedom, which involves both positive and negative aspects. Positive freedom refers to a situation in which people have the ability to participate in government; negative freedom means a situation in which people are free from arbitrary interference from government. Modern democracy adheres to the dual principles of popular sovereignty and individual liberty, but has its own distinctive features. Ideal as the principle of popular sovereignty may be, it is technically impossible to let the people in a nation-state decide everything. As a result, modern democracies are representative, not participatory (or direct). The principle of popular sovereignty in modern times hinges on two major mechanisms: the separation of powers and the competitive election. While the ruled choose their rulers during an election, rulers are mutually checked and balanced before and after the election. In determining the nature of a particular political system, the competitive election is more important than the separation of powers. A division of labor is employed in any government, particularly a modern one. Despite the importance of liberalism for modern democracy, popular sovereignty precedes individual liberty. Popular sovereignty talks about the purpose of government; individual liberty comprises the notion of government. The term that means â€Å"people† has undergone great changes in terms of class, education, gender, race, and age. Besides, individual liberty is historically and culturally specific. In the twentieth century, democracy and totalitarianism are regarded as two ends of the political spectrum. To put it in terms of ideal types, a government respecting both popular sovereignty and individual liberty is democratic; a government violating them is totalitarian. Falling somewhere in between, most systems are neither democratic nor totalitarian in the strictest sense of the terms. Some may respect popular sovereignty but violate individual liberty; others may violate popular sovereignty but respect individual liberty. Today’s Islamic Republic of Iran and eighteenth-century Britain are cited as respective examples of these two types. Throughout human history, not many regimes have ever been totalitarian and most have been authoritarian. Compared with totalitarian regimes, authoritarian regimes are less willing and less able to damage people’s rights and interests. The United States of America when compared to China or Cuba, presents the example of â€Å"democratic† democracy towards which China or Cuba should strive. Because now, when we took a closer look at the notion of democracy in the modern world, we are going to analyze the kind of democratic situation and democratic changes that took place in two of the most controversial countries in the world: China and Cuba. To reach conclusions as to the qualitative aspects of Cuban politics in the post-transition era, we will examine aspects of political culture as they relate to the formation and practices of civil society in democracy. From this angle one can interpret some key dimensions of politics in particular settings. Transition to democracy (and its consolidation) depends on a multiplicity of factors, including elite decisions, institutional arrangements, pacts between competing social actors, a constitution and organizations typical of liberal democracies, a favorable moment in world history, supportive international structures, and a measure of good luck. Political and economic factors also impinge on the likelihood of democratic transitions and survival. But political and economic factors determine neither transition to democracy nor democratic stability. The impact of the economy on democracy is not automatic, unidirectional, or necessarily predictable. According to Mattiace and Camp (1996), democracy is the product of multiple causes working together. In contexts where the system confronts unresolved foundational issues and consensus is elusive – on such matters as how the political community is defined, who has authority, what the rules of the game are – political questions become an affair of the heart, lending themselves less to compromise and pragmatism. As a result, democracy tends to be endangered, particularly in places where institutional democratic norms are weak and personalism is high. This is likely to occur in Cuba after Fidel Castro (as it has before and during the socialist years). Though democracy will be established in Cuba sometime in the future, Cuban democracy will not conform to normative models of liberal democracy. Democracy in the way it is in Cuba will be characterized by features of incivility in civil society. The democracy that is most likely to emerge on the island will be far from perfect, will share striking continuities with the past, and will dash the hopes of many who dream of democracy. The cynicism about democracy also has a long genealogy in Cuban intellectual history. As far back as the nineteenth century cultural pessimists on the island have remarked on the frustration that has followed modern projects of independence, nationalism, republicanism, and democracy. Democratic aspirations have a long history on the island, as long as the trajectory of their frustration. The notion is not as alien to Cuban soil as many believe (Dealy, 1996)

Holden Account Management

efox Account Plan Account: ANZ Operations and Technology Pvt Ltd Total WSP Revenue: $40,000 Total CDSP Revenue: $0 Sales Professional: Amit D Bhattacharya 29/11/2010 Page 1 of 12 efox by Holden International www. holdenintl. com efox Account Plan Corporate Goals & Initiatives Corporate Goals: undefined Corporate Initiatives: undefined 29/11/2010 ANZ Operations and Technology Pvt Ltd Page 2 of 12 efox by Holden International www. holdenintl. com efox Winning Sales Plan Account: ANZ Operations and Technology Pvt Ltd Opportunity: NPLC Bangalore-Mumbai Value: $40,000 Close Date: May 11 2010 Sales Professional: Amit D Bhattacharya Sales Prediction Opportunity is closed 29/11/2010 Page 3 of 12 efox by Holden International www. holdenintl. com efox Winning Sales Plan Discovery Expanded Opportunity Analysis Solid Emerging Weak Non-existent Excellent Good At parity Marginal Bad Disadvantaged Tentative Disconnected Severely at Risk Strong Growing At Risk Nov 29 2010 Dominant Secure Value Premise Business Quality Competitive Strength Political Alignment Summary Can We Add Value? – Value Premise Client Involvement in Value Discovery Business Impact -11 0 Driving Mechanism Measurability -3 -4 -3 0 -3 0 -15 -4 Should We Pursue? – Business Quality Geography/Resourceable Funding Risk Assessment Future Value to Us 0 0 0 Time frame Client Competence Profitability to Us 0 Can We Compete? – Competitive Strength Solution Compatibility Client History Philosophical Alignment 0 0 Competitor's Solution Compatibility Competitor's Client History -4 -3 -4 -27 -4 -3 -56 Competitor's Philosophical Alignment -4 Are We Politically Aligned To Win? – Political Alignment Decision-Making Process Leverage Political Leverage Appropriate Executive Sponsorship Established Momentum -4 -4 -4 0 Competitor's Decision Process Leverage -4 Competitor's Political Leverage Competitor's Approp. Exec. Sponsorship -4 Competitor's Established Momentum Total Score 29/11/2010 ANZ Operations and Technology Pvt Ltd NPLC Bangalore-Mumbai Page 4 of 12 efox by Holden International www. holdenintl. com efox Winning Sales Plan Establish Value Value Statements Sharath S, Lead – Technology, O We can provide the ethernet link as needed by you to reduce the choking and proper running of the applications as the current bandwidth is choked. Critical Business Issues Traffic is very high on the existing link which leads to choking Area of Improvement Upgrading of the bandwidth capability in the existing link Business Impact Credibility Need to release the choking and Track record of having provided the IT applications will run more similar links to Sonata Software, smoothly IBM etc Value Proposition Beginning April 28th 2010 as a result of the new link from TTSL, ANZ Operations and Technology Pvt Ltd will be able to effectively increase the bandwidth on the existing link resulting in effective removal of the choking for proper running of the IT applications with the economic payback of increased productivity of employees. We will document our delivered value by **. 29/11/2010 ANZ Operations and Technology Pvt Ltd NPLC Bangalore-Mumbai Page 5 of 12 efox by Holden International www. holdenintl. com efox Winning Sales Plan Competitive Strategy Differentiation Analysis Our Strategy Competitor Strategy for Strategy Coaching Prompt 29/11/2010 ANZ Operations and Technology Pvt Ltd NPLC Bangalore-Mumbai Page 6 of 12 efox by Holden International www. holdenintl. com efox Winning Sales Plan Political Support Support Base Map MV VM RP SS VB RP Ravi Pangal, Head – Transitions, E Agenda: Contribution: VM Viswas M, Head – IT strategic Sourcing and asset Management, M Agenda: Contribution: VB Vaidyanathan B, Manager Facilities, O Agenda: Contribution: MV Mahendran V, Head – IT Infrastructure, M Agenda: Contribution: SS Sharath S, Lead – Technology, O Agenda: Contribution: 29/11/2010 ANZ Operations and Technology Pvt Ltd NPLC Bangalore-Mumbai Page 7 of 12 efox by Holden International www. holdenintl. com efox Winning Sales Plan Ravi Pangal, Head – Transitions, E Agenda: Contribution: Fox Evaluator 2 3 4 5 6 7 8 9 10 Ravi Pangal has exerted influence outside of his or her organizational authority Ravi Pangal has knowledge of his or her company's mission and business goals, as evidenced in his or her working to directly or indirectly advance them Ravi Pangal is an effective risk taker, in terms of his or her ability to assess and manage risk Ravi Pangal demonstrates integrity, in terms of not being willing to compromise his or her company or individuals within the Power Base to advance his or her own aspirations Ravi Pangal is a good listener Ravi Pangal can appropriately and successfully work in exception to company policy Ravi Pangal influences important decisions before they are formally made Ravi Pangal has a close relationship with others who possess expertise that he or she personally does not have, but that can be important Ravi Pangal is not arrogant about his or her knowledge or accomplishments as evidenced by his or her willingness to have others receive the credit for accomplishments Ravi Pangal is diplomatic in how he or she operates, as evidenced by rarely taking people on in a confrontational manner 1-Most Likely True 0-Don't Know -1-Doubt this is true -2 -2 -2 -2 -2 -2 -2 -2 -2 -2 2-Confident this is true -2-Confident this is not true Contact Evaluator 1 2 3 4 5 6 7 8 9 10 My discussions with Ravi Pangal touch upon potential opportunities beyond the curre nt business opportunity Ravi Pangal utilizes e or my company as a nontraditional resource through which value can be derived Ravi Pangal makes an effort to assist me in cost-justifying the value that we can contribute Ravi Pangal introduces or references me to influential people in the account Ravi Pangal has a clear strategy for establishing us as the preferred supplier Ravi Pangal utilizes his or her internal contacts to provide me with business insights and information of a privileged nature Ravi Pangal openly discusses his or her company's plans, projects, and personnel with me Ravi Pangal can articulate my personal or company's long-term strategy for building a relationship with his or her company and how the current opportunity contributes to its advancement Ravi Pangal takes the initiative in assisting me in the current business development opportunity I feel my relationship with Ravi Pangal transcends the business development opportunity at hand 2-Almost Always 1-Often 0-Som etimes -1-Rarely -2-Almost Never -2 -2 -2 -2 -2 -2 -2 -2 -2 -2 29/11/2010 ANZ Operations and Technology Pvt Ltd NPLC Bangalore-Mumbai Page 8 of 12 efox by Holden International www. oldenintl. com efox Winning Sales Plan Viswas M, Head – IT strategic Sourcing and asset Management, M Agenda: Contribution: Fox Evaluator 1 2 3 4 5 6 7 8 9 10 Viswas M has exerted influence outside of his or her organizational authority Viswas M has knowledge of his or her company's mission and business goals, as evidenced in his or her working to directly or indirectly advance them Viswas M is an effective risk taker, in terms of his or her ability to assess and manage risk Viswas M demonstrates integrity, in terms of not being willing to compromise his or her company or individuals within the Power Base to advance his or her own aspirations Viswas M is a good listener Viswas M can appropriately and successfully work in exception to company policy Viswas M influences important decisions before they are formally made Viswas M has a close relationship with others who possess expertise that he or she personally does not have, but that can be important Viswas M is not arrogant about his or her knowledge or accomplishments as evidenced by his or her willingness to have others receive the credit for accomplishments Viswas M is diplomatic in how he or she operates, as evidenced by rarely taking people on in a confrontational manner 1-Most Likely True 0-Don't Know -1-Doubt this is true -2 -2 -2 -2 -2 -2 -2 -2 -2 -2 2-Confident this is true -2-Confident this is not true Contact Evaluator 2 3 4 5 6 7 8 9 10 My discussions with Viswas M touch upon potential opportunities beyond the current business opportunity Viswas M utilizes me or my company as a nontraditional resource through which value can be derived Viswas M makes an effort to assist me in cost-justifying the value that we can contribute Viswas M introduces or references me to influential people in the account Viswas M has a clear strategy for establishing us as the preferred supplier Viswas M utilizes his or her internal contacts to provide me with business insights and information of a privileged nature Viswas M openly discusses his or her company's plans, projects, and personnel with me Viswas M can articulate my personal or company's long-term strategy for building a relationship with his or her company and how the current opportunity contributes to its advancement Viswas M takes the initiative in assisting me in the current business development opportunity I feel my relationship with Viswas M transcends the business development opportunity at hand 2-Almost Always 1-Often 0-Sometimes -1-Rarely -2-Almost Never -2 -2 -2 -2 -2 -2 -2 -2 -2 -2 29/11/2010 ANZ Operations and Technology Pvt Ltd NPLC Bangalore-Mumbai Page 9 of 12 efox by Holden Internation al www. holdenintl. com efox Winning Sales Plan Vaidyanathan B, Manager Facilities, O Agenda: Contribution: Fox Evaluator 2 3 4 5 6 7 8 9 10 Vaidyanathan B has exerted influence outside of his or her organizational authority Vaidyanathan B has knowledge of his or her company's mission and business goals, as evidenced in his or her working to directly or indirectly advance them Vaidyanathan B is an effective risk taker, in terms of his or her ability to assess and manage risk Vaidyanathan B demonstrates integrity, in terms of not being willing to compromise his or her company or individuals within the Power Base to advance his or her own aspirations Vaidyanathan B is a good listener Vaidyanathan B can appropriately and successfully work in exception to company policy Vaidyanathan B influences important decisions before they are formally made Vaidyanathan B has a close relationship with others who possess expertise that he or she personally does not have, but that can be important Vai dyanathan B is not arrogant about his or her knowledge or accomplishments as evidenced by his or her willingness to have others receive the credit for accomplishments Vaidyanathan B is diplomatic in how he or she operates, as evidenced by rarely taking people on in a confrontational manner 1-Most Likely True 0-Don't Know -1-Doubt this is true -1 0 0 -1 1 0 1 0 -2 0 2-Confident this is true -2-Confident this is not true Contact Evaluator 2 3 4 5 6 7 8 9 10 My discussions with Vaidyanathan B touch upon potential opportunities beyond the current business opportunity Vaidyanathan B utilizes me or my company as a nontraditional resource through which value can be derived Vaidyanathan B makes an effort to assist me in cost-justifying the value that we can contribute Vaidyanathan B introduces or references me to influential people in the account Vaidyanathan B has a clear strategy for establishing us as the preferred supplier Vaidyanathan B utilizes his or her internal contacts to provide me with business insights and information of a privileged nature Vaidyanathan B openly discusses his or her company's plans, projects, and personnel with me Vaidyanathan B can articulate my personal or company's long-term strategy for building a relationship with his or her company and how the current opportunity contributes to its advancement Vaidyanathan B takes the initiative in assisting me in the current business development opportunity I feel my relationship with Vaidyanathan B transcends the business development opportunity at hand 2-Almost Always 1-Often 0-Sometimes -1-Rarely -2-Almost Never 0 -1 0 0 1 -2 -1 0 -1 -1 29/11/2010 ANZ Operations and Technology Pvt Ltd NPLC Bangalore-Mumbai Page 10 of 12 efox by Holden International www. holdenintl. com efox Winning Sales Plan Mahendran V, Head – IT Infrastructure, M Agenda: Contribution: Fox Evaluator 1 2 3 4 5 6 7 8 9 10 Mahendran V has exerted influence outside of his or her organizational authority Mahendran V has know ledge of his or her company's ission and business goals, as evidenced in his or her working to directly or indirectly advance them Mahendran V is an effective risk taker, in terms of his or her ability to assess and manage risk Mahendran V demonstrates integrity, in terms of not being willing to compromise his or her company or individuals within the Power Base to advance his or her own aspirations Mahendran V is a good listener Mahendran V can appropriately and successfully work in exception to company policy Mahendran V influences important decisions before they are formally made Mahendran V has a close relationship with others who possess expertise that he or she personally does not have, but that can be important Mahendran V is not arrogant about his or her knowledge or accomplishments as evidenced by his or her willingness to have others receive the credit for accomplishments Mahendran V is diplomatic in how he or she operates, as evidenced by rarely taking people on in a confr ontational manner 1-Most Likely True 0-Don't Know -1-Doubt this is true -2 -2 -2 -2 -2 -2 -2 -2 -2 -2 2-Confident this is true -2-Confident this is not true Contact Evaluator 2 3 4 5 6 7 8 9 10 My discussions with Mahendran V touch upon potential opportunities beyond the current business opportunity Mahendran V utilizes me or my company as a nontraditional resource through which value can be derived Mahendran V makes an effort to assist me in cost-justifying the value that we can contribute Mahendran V introduces or references me to influential people in the account Mahendran V has a clear strategy for establishing us as the preferred supplier Mahendran V utilizes his or her internal contacts to provide me with business insights and information of a privileged nature Mahendran V openly discusses his or her company's plans, projects, and personnel with me Mahendran V can articulate my personal or company's long-term strategy for building a relationship with his or her company and how the current opportunity contributes to its advancement Mahendran V takes the initiative in assisting me in the current business development opportunity I feel my relationship with Mahendran V transcends the business development opportunity at hand 2-Almost Always 1-Often 0-Sometimes -1-Rarely -2-Almost Never -2 -2 -2 -2 -2 -2 -2 -2 -2 -2 29/11/2010 ANZ Operations and Technology Pvt Ltd NPLC Bangalore-Mumbai Page 11 of 12 efox by Holden International www. holdenintl. com efox Winning Sales Plan Sharath S, Lead – Technology, O Agenda: Contribution: Fox Evaluator 2 3 4 5 6 7 8 9 10 Sharath S has exerted influence outside of his or her organizational authority Sharath S has knowledge of his or her company's mission and business goals, as evidenced in his or her working to directly or indirectly advance them Sharath S is an effective risk taker, in terms of his or her ability to assess and manage risk Sharath S demonstrates integrity, in terms of not being willing to compromise h is or her company or individuals within the Power Base to advance his or her own aspirations Sharath S is a good listener Sharath S can appropriately and successfully work in exception to company policy Sharath S influences important decisions before they are formally made Sharath S has a close relationship with others who possess expertise that he or she personally does not have, but that can be important Sharath S is not arrogant about his or her knowledge or accomplishments as evidenced by his or her willingness to have others receive the credit for accomplishments Sharath S is diplomatic in how he or she operates, as evidenced by rarely taking people on in a confrontational manner 1-Most Likely True 0-Don't Know -1-Doubt this is true -2 0 -1 0 1 -2 1 1 -2 1 2-Confident this is true -2-Confident this is not true Contact Evaluator 2 3 4 5 6 7 8 9 10 My discussions with Sharath S touch upon potential opportunities beyond the current business opportunity Sharath S utilizes me or my company as a nontraditional resource through which value can be derived Sharath S makes an effort to assist me in cost-justifying the value that we can contribute Sharath S introduces or references me to influential people in the account Sharath S has a clear strategy for establishing us as the preferred supplier Sharath S utilizes his or her internal contacts to provide me with business insights and information of a privileged nature Sharath S openly discusses his or her company's plans, projects, and personnel with me Sharath S can articulate my personal or company's long-term strategy for building a relationship with his or her company and how the current opportunity contributes to its advancement Sharath S takes the initiative in assisting me in the current business development opportunity I feel my relationship with Sharath S transcends the business development opportunity at hand 2-Almost Always 1-Often 0-Sometimes -1-Rarely -2-Almost Never -2 -2 -2 -1 -2 -2 -2 -2 0 0 29/11/20 10 ANZ Operations and Technology Pvt Ltd NPLC Bangalore-Mumbai Page 12 of 12 efox by Holden International www. holdenintl. com

History Sba

Acknowledgement First I would like to thank god for giving me the strength and ability to complete this project. I would also like to extend my heartfelt gratitude to the following persons who have made the completion of this assignment possible. My Teacher, Mr. Harvey, for giving me this project as I have learnt many things about The Trans-Atlantic Slave Trade, the effects it had on Africa and African arrival into the new world. My Bother, who helped me with the collection of data and My family and friends for the constant reminders and encouragement to remain committed to the task at hand. Table of ContentsTopics Page # Introduction iv The Negative And Postive Effects of The Trans-Atlantic Slave Trade: 1 Negative Social Effects 2-3 Negative Economical Effects 4-5 Negative Political Effects 6-7Positive Effects 8 Conclusion 9 Bibliography 10 Appendices 11 Candidate’s Name: Toniqui Adams Candidate’s #: Centre #: School’s Name: Meadowbrook HighIntroduction Th is project will be about the Effects the Atlantic slave trade, also known as the Transatlantic slave trade had on Africa, this was the trade of African people supplied to the colonies of the New World that occurred in and around the Atlantic Ocean. It lasted from the 16th century to the 19th century. Most slaves were shipped from West Africa and Central Africa and taken to the New World . Generally slaves were obtained through coastal trading with Africans, though some were captured by European slave traders through raids and kidnapping and this led to the great period ofAfrican hardship, turmoil and the coming of Africans to the New World now known as North, Central and South America and the West Indies. The main aim of this project is to show whether the Trans-Atlantic Slave Trade had more negative effects than positive effects on Africa. Negative Social Effects The trans-Atlantic had a lot of negative social effects as it led to the removal of millions of young men and women led to depopulation that stifled African creativity and production. It led to general feeling of insecurity in African societies as Africans ere afraid of being captured and then enslaved, which caused persons to abandon their homes and relocate to be secure from the threat of slave raids and some areas however encountered overpopulation as people sought safety and protection from the trade, in remote areas where the soil was not so good and they were unable to grow enough crops to feed themselves. Africa became a continent of violence, war, fear and famine. The men who remained or was left behind in Africa began to take on second and third wives, mostly to produce more children, a ready source for the slave market.As greed and insatiability for money grew, raising children became a business many women often had their children kidnapped and enslaved. Africa also lost more men than women in the slave trade and this caused the balance of society to be distorted. This eventually generated crucial environmental effects. The trade contributed to the diminishing of brotherhood and community spirit in African societies as Africans began to capture other Africans for money and European wealth, communities fell apart because of slave raids which destroyed villages and left some Africans dead and others homeless.It also led to the degrading of certain religious cultures, as they were warped to complete the needs of the slave trade. Kings, chiefs and rich merchants exploited the common people by bartering them to African traders and Europeans for guns, cloth and metal wears. (Appendix 1) According to J. D Fage â€Å"King Tegbesu of Dahomey made ? 250,00 a year by selling slaves in 1750, this was even more than an English duke’s income. † Families were also disrupted, they were left with orphans, families with single parents and in some cases some families did not survive slave raids. In addition they did not have the ccustomed support system as to help in provi ding security, health and community spirit. It also led to some Africans losing their culture and some lost their identity as they were brought to the New World (Appendix 2) and was exposed in learning the cultures of the Americas and the language and names used in the Americas this led to persons cutting their ties with their culture in Africa. The Slave Trade led to the Africans having low self-esteem because they were effectively turned into a commodity to facilitate the trade, that impacted the self image of the Africans despite heir enormous amount of talent, and resources that the continent and its people are endowed with. So most Africans today, see themselves as inferior to Europeans. Negative Economical Effects on Africa The Trans-Atlantic slave trade had crucial negative economical effects on Africa. It caused a downfall of Africa’s economy as it stifled technological advancement, and created a class of elite rulers and traders. It led to many of Africa’s coa stal areas being dependent on slavery and human merchandise as many of Africa’s coastal areas had been exchanging humans for merchandise for centuries.Their economies were geared to slave exporting, and they were dependent on the commodities they obtained for slaves. Ceasing the slave trade caused economic hardship, especially for groups who had no products to substitute for slave exports. It also led to a decline in agriculture, owing to the devastation of land during slave raids and wars, the capture of farmers, and the abandonment, by farmers, of in favour of slavery. The mining industry was also ruined and the economy dominated by slaving and imported manufactured goods from Europe. Imports like firearms which helped ncreased inter-tribal wars, led to Africa giving away a lot of their wealth buying British-made firearms (of very poor quality) and industrial-grade alcohol. The trade robbed Africa of skilled craftsmen and helped to ruin the livelihood of those craftsmen who remained, for example cloth, iron, pots and hoes, were imported goods made in European factories, which were cheaper than the locally produced ones, and were bought with slaves. The Trade Brought underdevelopment to Africa as they were trading all their wealth and skilled persons to the Europeans for simple European goods and not luxury goods.Hugh Thomas stated that â€Å"The shortage of blacks threatened the total ruin of the kingdom , for the black slave is the basis of the hacienda and the source of wealth which the realm produced. † The continent’s human resources were kidnapped, kept in dehumanizing Barracoons (appendix 3) and sold out to eager and willing buyers and were shipped in more barbaric and appalling conditions (Appendix 4) on the slave ships to the New World where most of them died or laboured perpetually to build the New World without due compensation and thus Africa was raped of future leaders, prospective uilders and this led to Africa setting back a lot of progress made by many African Societies. The trade led to an influx of interior European goods and this undermined local industries, especially salt-making, the manufacturers of cotton goods and metal- ware. It about a sense of insecurity that discouraged economic enterprises and it also led to some traditional art being inferior to those previously produced and thus Africa lost out on the creative art works because its standards became very low. Africa’s wealth began to drift and went to European countries and thus Africa became nderdeveloped and began to suffer an economical crisis. Negative Political Effects The Trans-Atlantic Slave Trade had major negative political effects on Africa. It led to a rise of professional armies as big the influence the European imported guns had on Africa. This however, many wars and conflicts among Africans because the demand for slaves usually went hand in hand with the demand for guns. The slave trade caused political instability, weakened states, promoted political fragmentation and resulted in a deterioration of domestic legal institutions.In many cases the village chiefs had a say in the negative effects on Africa as most of them were corrupted and greedy for European wealth. The village leaders made laws and if disobeyed Africans would be punished by being sold into slavery to the Europeans. The political system was undermined and in addition the legal system was also undermined. This was because the feeling of Superiority the village chief felt with guns. This led to military skills in some areas becoming more important than the traditional political systems. States such as Benin , Oyo and Dahomey acquired the trength to expand and impose their authority upon their neighbours from the economic prosperity derived from the slave trade. The influence of the trade tended strongly towards the corruption of the judicial process, with law breakers being often sentenced to slavery for minor offences and the inn ocent declared guilty in order to augment the supply of slaves. Aggressive tribalism increased, and in some cases whole tribes and nations were virtually destroyed as a result. Slave trading built up the power of chiefs where it was already present, from a broadly representative character into an autocratic one.It also caused an emergency of a number of large and powerful kingdoms that relied on a militaristic culture of constant warfare to generate the great numbers of human captives required for the trade with the Europeans. Some kingdoms began to expand rapidly as a result of this commerce trading slaves for firearms. These kingdoms with their formidable army, aided by advanced iron technology, captured immense numbers of slaves that were profitably sold to traders. The aggressive pursuit of slaves through warfare and raiding led to the ascent of these kingdoms being a major slave exporter.Positive Effects In spite of being overwhelmingly detrimental to Africa the slave trade did have some positive effects. Social Effects It brought about into being a class of merchants and businessmen who were able to meet and deal with their counterparts on equal terms, and the entrepreneurial spirit of West Africans stimulated as a result. Economic Effects Agriculture production in the coastal areas received a boost, brought about by the demand for provisions for both the slave ships and the prisons in which the slaves were kept before being shipped. The crops grown included maize and cassava, Appendix 5) both of these had been introduced from the Americas by the slave trade, and both became staple crops of Africa. Political Effects. There were political benefits to Africa from the slave trade because some members of the African elite benefited from the trade. Some of them were directly involved in the trade and gained a lot of firearms and European wealth and thus making them wealthy in their villages . Conclusion The immense misery and suffering prod-Atlantic slave tra de cannot be measured. It was the greatest and most inhumane trade of this type the world has ver known, far worse than that of the Arab slave trade, or that carried on across the Sahara. It can be said that a few positive effects that Africa gained was only beneficial for slave traders, Europeans and village chiefs and was nothing compared to the turmoil and suffering that was bestowed on Africa. The rights that were deprived from the Africans, millions of lives were lost, families were torn apart and Africa was destroyed in all aspects. It breathed such new life into African slavery that by the beginning of the twentieth century there were still several million slaves to be found in Africa.The shortage of man power had a great economic impact and this helped to destroy Africa’s valuable economy. Africa was so ruined that the few positive effects could not heal Africa’s slavery scars and it is perhaps not too difficult to see a connection between Africa then and the u nder-development of present day Africa. Bibliography Claypole, W. and John Robottom, Caribbean Story, Book one: Longman Publishers, 1990 Hamilton-Willie, D. Lest You forget, Caribbean Economy and Slavery: Jamaica Publishing House Ltd, 2001. Greenwood, R. and Hamber, S, Amerindians to Africans: Macmillan Publishers Ltd, 2003J. D Fage , The History Of West Africa: Cambridge University Press Publishers, 1969. Hugh Thomas, The Slave Trade, The Story Of The Trans Atlantic Slave Trade, 1440-1870: Simon & Schuster Publishers Ltd, 1997. Websites: Africanhistory. about. com Antislavery. org Appendix 1 Osnaburg Cloth and Guns traded for slaves. Appendix 2 Slaves Conformed on the plantations wearing Osnaburg Clothes. Appendix 3 Slave Barracoon Appendix 4 Slaves chained aboard the ship in barbaric conditions. Appendix 5 Crops Gown on the coast to provide food for the slave ships (Cassava and Maize).

Corporate Fraud in Richards Letter Essay Example | Topics and Well Written Essays - 1500 words

Corporate Fraud in Richards Letter - Essay Example The seriousness of Richard’s action against Richard, as the global head of sales, in the Computer Associates Corporation, he was involved in various acts, which affected his responsibilities in the company. One of his actions was the facilitation of an extension of the fiscal quarter (Soltes 4). This was indeed serious since it affected the reporting of the other fiscal quarters. The effectiveness of the information reported by extension of a fiscal quarter would be affected. Richard was also accused of allowing his subordinates to obtain contracts after the end of a fiscal quarter (Soltes 4). This is serious because it will influence the accuracy of the financial reports used by the stakeholders. The accuracy of financial information for the organization is remarkably essential for both the management and other stakeholders involved such as the investors. Inaccurate financial information may affect the expectations of the prospecting investors and shareholders of the organiza tion. It is better for an organization to give accurate financial information rather than falsehood representation. Information represented falsely can lead to extortion of investors emanating from misleading financial information. ... Although the actions of Richard emanated from the company’s culture of maintaining its performance, the actions of Richard did not follow ethical standards. When proper accounting approaches according to GAAP are used, accurate and efficient financial information is obtained. The chief reason for carrying out investigations on Computer Associates Company was because SEC doubted the accounting reporting of the company. When GAAP approaches are not used in a company’s financial reporting, it is most likely that the company’s financial reporting would have problems. For instance, one of the GAAP approaches is the matching principle, where revenues are recognized in the period of their earning or in the period when expenses that match the revenues are paid. In Computer Associates Company, there was a problem regarding the recognition of revenues. It was noted that; some of the contracts were signed after the last day of a fiscal quarter. This had an impact on the rec ognition of revenues since revenues obtained from the contracts signed after the end of a trading quarter, could either be related to the first quarter or the following fiscal quarter. Falling of stocks by 42% and fall in expected financial results in the first quarter of 2001 made SEC notice that some accounting procedures of the company were not proper (Soltes 3). If the company achieved the same accounting results through GAAP, it would have implied that there could be other contributing factors other than the use of wrong accounting principles. For instance, there could be a misappropriation of funds, which could also be investigated by the relevant authorities.  

The Different Aspects of Reality Essay Example | Topics and Well Written Essays - 1000 words

The Different Aspects of Reality - Essay Example Obviously, this is all fantasy as a falling star cannot be caught, and mandrake roots and mermaids are purely mythological. This fantastic imagery helps to reveal the imaginary and impossible theme of Donne’s poem. Nevertheless, such impossibility teaches the reader to be realistic and to realize that there is no perfect lover in the world. Although it is the fantasy that masks John Donne’s realism in â€Å"Song,† Frederick Nims’ â€Å"Love Poem† is downright honest in saying that perfect love does not exist and that if one loves another then one has to embrace all of his or her lover’s shortcomings. Nims uses the imagery of an unskilled and disorganized woman in revealing the reality of imperfections in relationships. In the first stanza, Nims describes his lover as his â€Å"†¦clumsiest dear, whose hands shipwreck vases† and someone â€Å"at whose quick touch all glasses chip and ring† (Nims 366). Such a woman, as depicte d by the imagery, is always making mistakes. She is also known as an â€Å"unpredictable dear, the taxi driver’s error† as well as a â€Å"Misfit in any space/ And never on time† (366). She is, therefore, lacks finesse and punctuality. Nevertheless, although she is â€Å"Forgetting [her] coffee spreading on [their] flannel,† the poet and she are â€Å"so gaily in love’s unbreakable heaven† (366). This means that no matter how careless and imperfect she is, the point is that they love each other so much. Love, therefore, can bloom despite the imperfection, and this is real love. One should, therefore, love his or her lover despite all his or her shortcomings. The imagery in the final stanza reveals a rather exaggerated form of acceptance of one’s lover: â€Å"Smash glasses/ I will study wry music for your sake† (366). This means that no matter how clumsy the lover is, as long as there is love, there is a necessity to wholehearte dly embrace all his or her imperfections. The exaggerated imagery of the last two lines then ultimately reveals that one’s happiness even depends on such an imperfection: â€Å"For should, your hands drop white and empty/ All the toys of the world would break† (366). This simply means one thing – without such lover’s hands, no matter how imperfect the labor that they produce is, nothing would be done at all, or without such an imperfect lover, there would be no happiness at all for the person who loves him or her. Although happiness is derived from imperfect reality, sometimes such reality is boring and one needs to make himself happy from his daydreams.  

How the relationship between the U.S. and Israel has effected Research Paper

How the relationship between the U.S. and Israel has effected relations with Iraq, Palestine, Iran, AndAfghanistan - Research Paper Example How the relationship between the U.S. and Israel has affected relations with Iraq, Palestine, Iran and Afghanistan America’s relations with Israel have significant effects on its relations with other countries in the Middle East. Arabs generally have a feeling that America is supporting Israel blindly and keeps a blind eye towards the massacres conducted by Israel against the Arab world in general and against Palestine in particular. America’s foreign policies towards Middle East are influenced by its historical and cultural relations with Israel. Israel’s relationships with America are so strong because of the cultural similarities of these two countries. No other country in the world has ever succeeded in maintaining such a strong and long relationship with US as Israel does. Moreover, no other country in the world is getting such big financial and military aids from America as Israel does. Mearsheimer & Walt (2008) have pointed out that â€Å"As of 2005, dire ct US economic and military assistance to Israel amounted nearly to $ 154 billion, the bulk of it comprising of direct grants rather than loans† (Mearsheimer & Walt, 2008, p.24). Moreover, â€Å"Israel's bombing of Iraq's Osirak nuclear reactor in 1981—despite formal criticism—was enthusiastically supported by the Reagan administration† (Zunes, 2006). Because of the strong relations with Israel, America never criticizes Israel even if Israel engages in illegal activities against the Arab world. ... They encouraged Taliban and Osama led Al-Qaida to fight against Soviet Union. They taught the Islamic fundamentalists that communism is against the religious beliefs and teachings of Islam. The rest is history now. America succeeded in expelling Soviet troops from Afghanistan; however, they forced to give huge prices for that later. The 9/11 incident and the current war on terror which destroyed the financial back bone of America were the outcomes of America’s injudicious efforts in Afghanistan earlier. â€Å"Despite the widely-held tail-wagging-the-dog assumptions, history has shown that the United States has frequently used Israel to advance its strategic interests in the Middle Eastern region† (Zunes, 2006). Neutral political observers quiet often confused to give proper answer to the question why United States is sacrificing its interests for Israel. In most of the issues in the Middle East region, America is playing its cards staying at the back drop. US donâ€℠¢t like the involvement of any other super powers in this region since the Middle Eastern region is blessed with immense natural resources like oil and fresh water. America is exploiting Israel-Arab enmity to block the interference of other superpowers in this region. However, America’s efforts are affecting them as a boomerang. â€Å"If the United States had not been a strong supporter of Israel, it would have been very difficult for Soviet Union to win friends and allies in the Islamic world†(Sheffer, 1997, p.32). At present most of the Arab countries like Iran, Palestine etc are in good relations with Russia. Moreover, America is facing stiff challenges in Afghanistan and Iraq. After the end of cold war and the defeat of

Church and world religion Essay Example | Topics and Well Written Essays - 1500 words - 1

Church and world religion - Essay Example Familiarity with Muslim communities enhanced acceptance by the interviewee and openness during the interview. Effective communication is important for a successful interview to take place. Most Islamic teachings are in Arabic and have not been interpreted explicitly in English. The interview therefore was characterized with communication snags as the interviewee tried to express certain meanings as understood from the Quran. It was interesting to find out how a Muslim is well-versed with the teachings of the Quran, quoting from different verses to support answers to the interview questions. There was also a notable affection of Islam as the respondent participated in the interview. The readiness to explain more than requested indicated an inner driving force for the Muslim to help others understand his own faith, which demonstrated the need for dialogue. Religion emerged as a core aspect of a Muslim’s life and that there is a day of judgment when every individual will be required to account for all his/her actions. Islam is a peaceful religion that teaches on the existence of one supreme God who is unique and without equal. It instructs believers to maintain peace with others and to follow the desires of God as manifest in His angels as well as the revelations that were conveyed to human beings through prophets. Every human being is supposed to obey God who holds the ultimate authority over mankind. For this reason, perpetrators of the crimes against humanity committed all over the world by Muslims and non-Muslims are against God’s will and every individual will pay the price of sin on judgment day. There are a number of prophets that are held in high regard by Muslims with whom they associate with God’s intention to bring peace to the world. This is an indicator that God intended to bring happiness to man despi te the sins that distance people from Him. It was also an important realization that some of the prophets are

Homelessness in the UK - what are the causes and its effect in the Dissertation

Homelessness in the UK - what are the causes and its effect in the society - Dissertation Example The houses of the people can also be destroyed by natural calamities like floods and hurricanes. (Main Causes of Homelessness, n.d.). The events of homelessness makes an individual all the more physically and psychologically unfit to live in. These people suffer from diseases like cold and insomnia. (Bodine, 2010). Aims The research paper on Homelessness in United Kingdom aims to achieve the following goals which can be listed as follows: 1. The causes which lead to making the people homeless in United Kingdom. 2. Effects of the factors which causes the people to become homeless on the life cycle of the people affected by such. 3. The changes brought about by the government through the introduction of policy measures aimed at preventing the people to become homeless. Objectives The objectives behind studying Homelessness in United Kingdom are to: 1. Identify the factors which cause the event of homelessness in United Kingdom. The identification of such factors would help focus on the safeguarding of communities from being made homeless. 2. Evaluate the potency of such impacts in disturbing the lives of the people in United Kingdom by making them physically and mentally impaired. The people put in the streets continually face the climatic changes which turns fatal for them. 3. Assess the amount of damages to life of the people rendered due to homelessness and policy measures taken if any to counter such. Scope of the Research The scope of the research paper is to underlie the causes which lead to the event of making people deprived of their homely or domestic environments. In that the paper endeavors to gauge the impact of such factors in immensely affecting the life patterns of the people residing in United Kingdom. The paper also divulges to find any significant policy measures taken by the government of the country in helping the people put in the streets to gain a better life. The research conducted gains due importance for it specifically focuses on a parti cular social evil which aims at snatching the basic means of living from the general population for which they also meet fatal incidents. The event of homelessness in United Kingdom has huge impact on the construction and housing business of the country. These families which were rendered homeless posed several types of complaints based on the houses rendered to them by the government of the country so as to counter the event. Homeless applicants who were rendered private homes to dwell in complained of lack of proper spaces to help them move away freely in the apartment. Further the location of the private buildings being near the crowded corners caused the occupants major disturbances in maintaining a silent environment in and around their homes. Further other special types of accommodation provided to the homeless people also countered huge problems for the rise in the amount of drug peddlers in the region. The people living in such households appeared to fear from the impacts of such people on affecting their children. For homeless people the best housing solution rendered by the United Kingdom government is to allow the local communities to build in permanent homes for them. Permanent homes build by the local authority for these people were favored above the temporary homes firstly because of their sense of security. However the government of

Risk Assessment and Risk Management Essay Example | Topics and Well Written Essays - 1500 words

Risk Assessment and Risk Management - Essay Example The essay "Risk Assessment and Risk Management" talks about the knowledge bases in risk assessment and risk management and the consensus-based model of risk assessment. The knowledge base is the foundation of any profession; this refers to a body of specialist knowledge, which acts as the base of professional practice. Therefore, it has become increasingly essential for individuals and organizations to demonstrate underpinning knowledge base while undertaking any task within human services, aimed at achieving professional status. In the development of a framework for risk assessment and risk management, three interweaving features of knowledge bases are needed: theoretical knowledge, practical or personal knowledge, and factual knowledge. The theoretical knowledge base includes the existing literature that analysis risk incidents, situations, or events, literature that analysis our role and tasks in risk assessment and risk management, and literature that offers guidance on the pract ical approaches to be followed in assessing and managing risks. Practical or personal knowledge base refers to the practical skills or knowledge that is acquired at workplace related to risk assessment and risk management. These practical skills may be acquired through training, or through learning from experience, which leads to new knowledge. Finally, factual knowledge refers to the professional standards, rules, regulations, and ethical values developed in the past to provide guidance during professional practice.

Signal Space Cooperative Communication Essay Example | Topics and Well Written Essays - 750 words

Signal Space Cooperative Communication - Essay Example This is possible with the help of expanded constellation; also it enables the destination to combine the received signals in the broadcast phase and the relay phase. Later the performance of the SSC scheme is analysed and numerical results are obtained, with the help of that result two design criteria are derived so that it can achieve the maximum performance from the system. Spatial diversity techniques are used in order to increase system reliability; also it won’t affect the bandwidth or performance. We use cooperative diversity as alternative to achieve special diversity, where antenna diversity become impractical due to size and power limitation of mobile devices. The concept of cooperation among users to provide diversity was introduced by Sendonaris, and then Laneman (Motahari, Ahmadzadeh & Khandani) derived the formulation for cooperative diversity based on two cooperative schemes, namely Amplify and Forward (AF), and Decode and Forward (DF). Signal space diversity was introduced by Belfiore and Boulle (Motahari, Ahmadzadeh & Khandani), which is achieved with the modulation signal space. Here we spread information carried by each signal point across all components of that particular signal point. And then send each component through an independent channel. The performance of the cooperative schemes, which uses the signal space diversity, is affected by the performance of the source-relay channel. Meanwhile, a method called Signal Space Cooperative (SSC) scheme has been proposed to overcome this problem however, which is not easy to scale larger constellations. And also here we take an assumption, that the destination is aware of whether the relay participates in the cooperative scheme or not. Signal Space Cooperative Scheme SSC scheme is the major proposal by this paper. To demonstrate SSC scheme, first we have to see the Constellation Expansion Algorithm that enables the relay to effectively cooperate during the course of transmission. Then, the broadcast phase and the relay phase signals are described followed by a discussion on how the destination decodes received signals. Constellation Expansion In order to achieve maximum diversity gain, any two signal points in the system constellation must have the maximum number of distinct components. Let us consider

What aspects of speech perception and preverbal communication prepare Essay

What aspects of speech perception and preverbal communication prepare infants for language development - Essay Example Language acquisition is partly learned and partly innate as infants interact with the people around them and their environment. For some children, picking up a language is the easiest thing in the world, but for others it is the hardest. Many factors are responsible for this such as genetic factors and factors relating to our family background, experiences and exposure. Tiny tots pick up the language without any formal training just by listening and practicing. They often surprise us with their use of words and phrases and often leave us wondering as to who taught them. For a child learning a language comes naturally by instinct. It doesn’t need to be taught, but nurtured and groomed. There is an ongoing debate about whether the human language gradually evolved from more primitive forms of communication like shouts, gestures or calls or whether the language feature is something unique to all humans. As Leaky (1994) states that â€Å"language is a defining point in human prehistory†, it is evident that language evolved. But the question is, did language evolve early, during the evolution of humans? Chomsky advocates that, â€Å"evolved as an ability that arose as a consequence of the growing brain and therefore appeared late in our evolution†. According to Tomassello 1999, the distinct feature of joint attention is what distinguishes us humans from apes. Therefore, the evolution of language is inextricably linked to joint attention. It is this feature that helps us to acquire knowledge and use it not only for communication but in the description of abstract things which are not within our reach. Primates are not capable of joint attention and therefore cannot learn a language well. The manner in which you engage a child would determine the path of how language learning takes place in a child in his formative years from one to five. This is a very exciting period you can really enjoy listening to a child. Talking

Art on Japanese Art History Essay Example for Free

Art on Japanese Art History Essay How can the artistic medium one chooses to use to express oneself determine whether or not it is truly art? While digital artists’ artistic ability is often questioned and the credit is given to the computer being used, the art itself springs from the mind of the digital artist. I can say this with personal fervor: Digital art is truly in essence a form of art that merely takes advantage of the innovations of modern technology. Digital Art isn’t computer-generated. While it might involve using tools offered by specialized computer programs a computer doesn’t do the thinking for you, and the creative ideas put forth are of the artist’s mind. Digital artist’s only use computer tools to convey their designs, all of the creative credibility should be given to the artist himself. Should the canvas the Mona Lisa was painted on be considered the creator of the masterpiece or rather Leonardo Da Vinci? Painters that stick to canvas are limiting themselves to the paint they use and the cotton woven fibers of their canvas. Why purposely choose to ignore the modern day tools that are given to you and condescendingly look down upon those who choose to utilize them? Over the years, I have spent a lot of my own time experimenting in the depths of digital art. Many times, I have used the computer as a medium for self expression; from creating to pictures on Microsoft paint as a child to experimenting with specialized software such as Adobe Photoshop. I have a deep and passionate love for creating and expressing myself through artwork on the computer. I one day aspire to have a profession in the field of digital art, such as a Graphic Designer. Because of this, I am very offended by the comments I hear from â€Å"traditional artists† that condescend digital art for its use of the computer as the artistic medium. When I hear comments that degrade digital artwork to computer-generated images, as though the computer itself designed the art I feel enraged and cheated. The other day a friend of mine ignorantly explained to me that she could, given the proper software, create her own masterpiece without any prior experience in digital art, as though anyone if given the proper software could instantaneously create masterpieces, when really there is so much more to digital art than computer software or the computer itself. It’s about one’s individual artistic talents. To me that would be the equivalent of saying that if I were given a canvas and a paintbrush I could instantaneously create a masterpiece, which I know is false and ignorant. Art is â€Å"the use of skill and imagination in the creation of aesthetic objects, environments, or experiences that can be shared with others† (Britannica). Digital art is a general term for a range of artistic works and practices that use digital technology as an essential part of the creative and/or presentation process. There are many different employment fields in digital art. A couple of examples are graphic design and web design. Graphic design is the process and art of combining text and graphics and communicating an effective message in the design of logos, graphics, brochures, newsletters, posters, signs, and any other type of visual communication. Famous Graphic Designer, Milton Glaser, says â€Å"to design is to communicate clearly by whatever means you can control or master. † A graphic designer would meet with his/her clients and discuss the type of visual communication the client is interested in. The client may provide a general idea for the design, but the creative options are left for the designer to decide how to best portray the message of the client. The designer would then either sketch out a design to scan on to the computer for further alterations or go directly to the computer software in order to design the desired product. The designer would then verify with the client for satisfaction of the product. Web Design is the art and process of creating a single Web page or entire Web sites and may involve both the aesthetics and the mechanics of a Web site’s operation although primarily it focuses on the look and feel of the Web site the design elements. â€Å"To be effective, the interfaces for online information systems must be as rich and flexible as the physical environments they replace. They must not only supply a direct path to reach the users goals, but must be able to accommodate different approaches to the task. This means that the interface design must not only organize the content for easy access, but must incorporate the right combination of technologies and interaction techniques to allow the user to work in their own style† (Quesenbery). A Web Designer would be sought out by a client in need of assistance in designing a website or website layout, usually for advertising and communicative purposes of the client. Like in Graphic design, the client may provide the designer with a general idea or guideline for the product, however, web designers must understand the dynamics of coding and html. Traditional art is understood to include things such as paintings, sculptures, and hand-drawings; basically any art which involves physical activity, usually of the hands. Famous Traditional Artists include: Leonardo DaVinci, Vincent Van Gough, and Andy Warhol. These artists use drawings and paintings as their forms of self expression which led to their innovative masterpieces: the Mona Lisa, Starry Night, and Pop Art, respectively. Traditional artists often look down upon the usage of the computer as the creative medium utilized when expressing oneself in art. Some believe that using a computer negates the creative ability of the artist and is the less credible form of art. Using computers in order to create art is sometimes seen as the easier method involving little artistic ability. â€Å"For artists diving into a new technology, it is a triple short-cut to mastery: you get a free ride on the novelty of the medium; there are no previous masters to surpass; and after a few weeks, you are the master† (Brand). There is a certain type of beauty in a hand-painted piece of art. The same is true for a masterfully drawn illustration. For this there is no substitute. Traditional art is the oldest form of art and could be considered the foundation of art. Many people consider this form of art to require the highest level of skill and creative ability, and that there is no other type of art form that can surpass it. There are a large number of people that believe this form of art is most vital, and that digital art simply shouldn’t be considered art due to the use of technology rather than their hands. Opponents of digital art argue that there is no skill in â€Å"pointing and clicking† on a computer screen. â€Å"I would rather choose the painting of a monkey over anything generated electronically, because I am more fascinated by the direct evidence of a mind at work than I am by the output of machines† (Glenn). Because of this belief, there is a good bit of animosity between the two different sects. Traditional artists feel as if they are protecting art in its truest form, whereas digital artists feel as if they are exposing the world to a newer and more advanced form of art infinitely full of possibilities. While traditional art is the older and more revered art form, that doesn’t mean that digital art is any less of an art. Both art forms require talent, precision, technique, and creativity from the artist. Digital artists are just as legitimate of artists as traditional artists. It is simply ignorant and petty to distinguish digital art as separate from true art in essence. Yes, computers are used as the medium for expression, however, like previously stated, that doesn’t mean that the computer creates the ideas and designs. The designs and creativity come from the artist and the computer is simply another way to release the idea from the artist’s mind, similar to a piece of paper or canvas. Digital art should be just as revered as traditional art because the amount of creativity and artistic ability is equal in both forms.

Radiation Protection for Angiography Procedure.

Radiation Protection for Angiography Procedure. Fluoroscopic procedure produces the greatest patient radiation exposure rate in diagnostic radiology. Therefore the radiation protection in fluoroscopy is very important. Several feature and techniques in fluoroscopy are designed for protection to the patient during fluoroscopic procedure. a) Protection to Patient * A dead-man switch is a device (switch) constructed so that a circuit closing contact can only be maintained by continuous pressure on the switch by the operator. Therefore, when the machine is turned on by any means, whether by the push button at the control panel, or by the foot pedal, this switch must be held in for the machine to remain on. * The on-time of the fluoroscopic tube must be controlled by a timing device, and must end alarm when the exposure exceeds 5 minutes. An audible signal must alert the user to the completion of the preset on time. This signal will remain on until the timing device is reset. * The X-ray tube used for fluoroscopic must not produce X-rays unless a barrier is in position to intercept the entire cross-section of the useful beam. The fluoroscopic imaging assembly must be provided with shielding sufficient that the scatter radiation from the useful beam is minimized. * Protective barriers of at least 0.25 mm lead equivalency must be used to attenuate scatter radiation above the tabletop. This shielding does not replace the lead garments worn by personnel. Scattered radiation under the table must be attenuated by at least 0.25 mm lead equivalency shielding. * Additionally, most c-arm fluoroscopes have a warning beeper or light that activate when the beam is on, some have both. Never inactivate any warning devices, and keep ones foot off the foot pedal whenever possible. * Methods of limiting radiation exposure include: o making certain that the fluoroscopy unit is functioning properly through routine maintenance, o limiting fluoroscopic exposure time, o reducing fields of exposure through collimation, o keeping the X-ray source under the table by avoiding cross-table lateral visualization when possible, and o bringing the image intensifier down close to the patient b) Protection to personnel There are therefore three basic ways to minimize dose: * Reduce time of exposure * Use the inverse square law-doubling your distance away quarter your exposure * Use shielding by barrier These basics known as Cardinal Principle which is important to achieved ALARA. i) Time Radiation dose is directly proportional to the time, those by doubling the radiation time the dose is doubled and by having the radiation time the doses halved. Many factors impact the on time of a fluoroscopic procedure. The exposure time is related to radiation exposure and exposure rate (exposure per unit time) as follows: Exposure time = Exposure/Exposure rate Exposure = Exposure rate x time The algebraic expressions simply imply that if the exposure time is kept short, then the resulting dose to the individual is small. Method of reducing exposure time include meticulous advanced planning of the procedure, judicious use of contrast enhancement, appropriate positioning of the patient, orientation of the fluoroscope unit prior to beginning the procedure. ii) Distance The second radiation protection action relates to the distance between the source of radiation and the exposed individual. The exposure to the individual decreases inversely as the square of the distance. This is known as the inverse square law, which is stated mathematically as: where I is the intensity of radiation and d is the distance between the radiation source and the exposed individual. For example, when the distance is doubled the exposure is reduced by a factor of four. In mobile radiography, where there is no fixed protective control booth, the technologist should remain at least 2 m from the patient, the x-ray tube, and the primary beam during the exposure. In this respect, the ICRP (1982), as well as the NCRP (1989a), recommended that the length of the exposure cord on mobile radiographic units be at least 2 m long. Another important consideration with respect to distance relates to the source-to-image receptor distance (SID). The appropriate SIDs for various examinations must always be maintained because an incorrect SID could mean a second exposure to the patient. Long SID results in less divergent beam and thus decreases the concentration of photons in the patients. Short SID results in the reverse action and increases the patient dose. Hence the longest possible SID should be employed in examinations. However, if a greater than standard SID is used then greater intensity of radiation would be required to produce the same film density. Therefore it is recommended that only standard SIDs should be used. iii) Shielding Shielding procedure the most utilitarian results in the reduction of staff dose as there are times when the procedure list simply must function in close proximity, even directly cines fluoroscopy. In these circumstances there simply is no substitute for the best modern flexible lead gloves, lead glasses, lightweight lead apron and lead lined thyroid shield available. Appropriate shielding is mandatory for the safe use of ionizing radiation for medical imaging. Other method of shielding includes beam collimation, protective drapes and panels. Shielding of occupational workers can be achieved by following methods: * Personnel should remain in the radiation environment only when necessary (step behind the control booth, or leave the room when practical) * The distance between the personnel and the patient should be maximized when practical as the intensity of radiation decreases as the square of distance (inverse square law). * Shielding apparel should be used as and when necessary which comprise of lead aprons, eye glasses with side shields, hand gloves and thyroid shields. Lead aprons are shielding apparel recommended for use by radiation workers. These are classified as a secondary barrier to the effects of ionizing radiation. These aprons protect an individual only from secondary (scattered) radiation, not the primary beam. The thickness of lead in the protective apparel determines the protection it provides. It is known that 0.25 mm lead thickness attenuates 66% of the beam at 75kVp and 1mm attenuates 99% of the beam at same kVp. It is recommended that for general purpose radiography the minimum thickness of lead equivalent in the protective apparel should be 0.5mm. It is recommended that women radiation workers should wear a customized lead apron that reaches below mid thigh level and wraps completely around the pelvis. This would eliminate an accidental exposure to a concept us. Other protective apparel included eye glasses with side shields, thyroid shields and hand gloves. The minimum protective lead equivalents in hand gloves and thyroid shields should be 0.5mm. Lead lined glass and thyroid shield likewise reduce 90% of the exposure to the eyes and thyroid respectively. Lead lined gloves reduce radiation exposure to the hands; however they are no substitute for strict observation of appropriate fluoroscopic hygiene. Gloves should be considered as an effective means of reducing scatter radiation only. 2. State five clinical indications for the patient undergo the angiography procedure. 3. Explain the patient care management before, during and after the procedure Before a procedure: * Patients undergoing an angiogram are advised to stop eating and drinking eight hours prior to the procedure. * They must remove all jewelry before the procedure and change into a hospital gown. * If the arterial puncture is to be made in the armpit or groin area, shaving may be required. * A sedative may be administered to relax the patient for the procedure. * An IV line will also be inserted into a vein in the patients arm before the procedure begins in case medication or blood products are required during the angiogram. * Be aware of and follow all Local Rules and protocols * Prior to the angiography procedure, patients will be briefed on the details of the test, the benefits and risks, and the possible complications involved, and asked to sign an informed consent form. * Ensure that all exposures are justified and there is informed consent * Check patient identity * Position patient comfortably flat, with arm above head where possible * Ensure all members of staff in room are wearing suitable. For operations this should be lead glasses, thyroid collar and wrap-around lead apron * Check all staff are wearing radiation monitors correctly * Use all available lead shielding appropriately sited * Position table before screening * Keep tube current as low as possible and kVp as high as possible for cardiac studies, 60 – 90 kV is appropriate * Keep x ray tube at maximum and image intensifier / receptor at minimum distance from patient * Check all staff are as far away as possible in their role * Use dose reduction programmers when possible * Perform acquisitions on full inspiration where possible * Collimate closely to area of interest * Prolonged procedures: reduce dose to the irradiated skin eg. Change beam angulations * Minimize fluoroscopy time, high dose rate time and no of acquisitions * Remember software features, such as replay fluoro to minimize dose * Dont over use geometric magnification * Remove grid for small patients or when image intensifier / detector cannot be placed close to patient * Check and record screening time and DAP at the end of the case and review against the DRL. During the procedure: * The radiologic technologist will position you on the exam table. A radiologist a physician who specializes in the diagnostic interpretation of medical images will administer a local anesthetic and then make a small nick in your skin so that a thin catheter can be inserted into an artery or vein. The catheter is a flexible, hollow tube about the size of a strand of spaghetti. It usually is inserted into an artery in your groin, although in some cases your arm or another site will be selected for the catheter. * The radiologist will ease the catheter into the artery or vein and gently guide it to the area under investigation. The radiologist will be able to watch the movement of the catheter on a fluoroscope, which is an x-ray unit combined with a television monitor. * When the catheter reaches the area under study, the contrast agent will be injected through the catheter. By watching the fluoroscope screen, the radiologist will be able to see the outline of your blood vessels and identify any blockages or other irregularities. * Angiography procedures can range in time from less than an hour to three hours or more. It is important that you relax and remain as still as possible during the examination. The radiologic technologist and radiologist will stay in the room with you throughout the procedure. If you experience any difficulty, let them know. * Angiography also can be performed using magnetic resonance instead of x-rays to produce images of the blood vessels; this procedure is known as magnetic resonance angiography (MRA) or magnetic resonance venography (MRV). After the procedure: * Because life-threatening internal bleeding is a possible complication of an arterial puncture, an overnight stay in the hospital is sometimes recommended following an angiography procedure, particularly with cerebral and coronary angiograms. * If the procedure is performed on an outpatient basis, the patient is typically kept under close observation for a period of at six to 12 hours before being released. * If the arterial puncture was performed in the femoral artery, the patient will be instructed to keep his leg straight and relatively immobile during the observation period. * The patients blood pressure and vital signs will be monitored and the puncture site observed closely. Pain medication may be prescribed if the patient is experiencing discomfort from the puncture, and a cold pack is applied to the site to reduce swelling. It is normal for the puncture site to be sore and bruised for several weeks. * The patient may also develop a hematoma, a hard mass created by the blood vessels broken during the procedure. Hematomas should be watched carefully, as they may indicate continued bleeding of the arterial puncture site. * Angiography patients are also advised to enjoy two to three days of rest and relaxation after the procedure in order to avoid placing any undue stress on the arterial puncture. Patients who experience continued bleeding or abnormal swelling of the puncture site, sudden dizziness, or chest pains in the days following an angiography procedure should seek medical attention immediately. * Patients undergoing a fluorescein angiography should not drive or expose their eyes to direct sunlight for 12 hours following the procedure. 4. Identify the type of contrast medium, the dose and delivering technique in angiography procedure. * Reducing radiation doses to the patient also generally reduces doses to the medical personnel. Â · Angiography procedure is using fluoroscopy imaging technique which is a real-time imaging technique. 5. List down the catheters and guide wires inclusive of size, shape and the hole type that are used in angiography procedures. The use of lead gloves during procedures is unusual as they are cumbersome and difficult to work in. The automatic brightness control will increase the exposure to go through two layers and one only protects the hand, so if they are going to be used a programme that sets the radiation factors rather than allowing adjustment may be appropriate. In practice, with careful collimation and attenuation to detail it should not necessary for the operators hand to be in the primary beam and only close to it for short periods. While doing catheterization, radiologist should do it behind the lead glass viewer which consists of lead equivalent glass of 0.25mm thickness. Geometric consideration is one of the important things in angiography because source of exposure to personnel is mainly from scattered radiation from the patient. So, it is important to minimize the amount of scattered radiation to personnel. This can be achieved by geometric consideration involving the x-ray tube, patient and image intensifier. The image intensifier should be as close as possible to patient to minimize the amount of scattered radiation hitting personnel. Because in angiography room is sterile for all things, personnel such as radiologist, nurses, radiographer or student should wear shoes which are prepared only. Make sure that film badges always outside personnel body to measure the dose receive to the personnel. The most important thing to remember is that all individuals should be fully trained and learned to be responsible for radiation safety. Involvement of a radiation expert is essential and is particularly useful in equipment specification, assessment and quality assurance, but also in the formulation of Local Rules. Technique Reduces Physician Radiation Exposure During Angiography Current technique requires that physicians performing radiation procedures wear lead gowns. The new technique involves use of a body length floor mounted lead plastic panel to protect to physicians as they monitor patients angiograms and control exam table movement. An extension bar allows the physician to remain safely behind the shield and still retain table control for panning. In the study, researchers recorded radiation exposure to various parts of a physicians body during 25 coronary angiography procedures and compared those results with radiation exposure during angiography on 25 patients using conventional radiation protection. A lead apron, thyroid shield, eyeglasses and facemask were used in both techniques, but a ceiling mounted shield was used in the conventional technique. The researchers placed radiation badges outside and inside the facemask; outside and inside the thyroid shield; on the right and left arm; outside and inside the lead apron; and on the right and left leg. The new equipment resulted in a 90 percent reduction in radiation exposure to the physicians head, arms, and legs. Exposure of the thyroid and torso was minimal with both techniques. Enhanced physician radiation protection during coronary angiography is readily achievable with this new technique, said Martin Magram, M.D., of the University of Maryland Medical Center in Baltimore, Md. Dr. Magram presented the study results on May 3 at the American Roentgen Ray Society Annual Meeting in Vancouver, British Columbia. Dr. Magram pointed out that by freeing physicians from the need to wear lead gowns, the new technique could preserve their ability to benefit patients. It may extend by years their ability to apply the skills they have developed over long careers of serving patients, noted Dr. Magram. New methods of radiation protection must parallel the development of new radiation techniques, added Dr. Magram. The key is to limit medical workers radiation exposure with effective and easy-to-use techniques, and the use of this extension bar and lead plastic shield may be such a technique. Definition Angiography is the x-ray study of the blood vessels. An angiogram uses a radiopaque substance, or dye, to make the blood vessels visible under x ray. Arteriography is a type of angiography that involves the study of the arteries. Purpose Angiography is used to detect abnormalities or blockages in the blood vessels (called occlusions) throughout the circulatory system and in some organs. The procedure is commonly used to identify atherosclerosis; to diagnose heart disease; to evaluate kidney function and detect kidney cysts or tumors; to detect an aneurysm (an abnormal bulge of an artery that can rupture leading to hemorrhage), tumor, blood clot, or arteriovenous malformations (abnormals tangles of arteries and veins) in the brain; and to diagnose problems with the retina of the eye. It is also used to give surgeons an accurate map of the heart prior to open-heart surgery, or of the brain prior to neurosurgery. Precautions Patients with kidney disease or injury may suffer further kidney damage from the contrast mediums used for angiography. Patients who have blood clotting problems, have a known allergy to contrast mediums, or are allergic to iodine, a component of some contrast mediums, may also not be suitable candidates for an angiography procedure. Because x rays carry risks of ionizing radiation exposure to the fetus, pregnant women are also advised to avoid this procedure. Description Angiography is usually performed at a hospital by a trained radiologist and assisting technician or nurse. It takes place in an x-ray or fluoroscopy suite, and for most types of angiograms, the patients vital signs will be monitored throughout the procedure. Angiography requires the injection of a contrast dye that makes the blood vessels visible to x ray. The dye is injected through a procedure known as arterial puncture. The puncture is usually made in the groin area, armpit, inside elbow, or neck. The site is cleaned with an antiseptic agent and injected with a local anesthetic. First, a small incision is made in the skin to help the needle pass. A needle containing an inner wire called a stylet is inserted through the skin into the artery. When the radiologist has punctured the artery with the needle, the stylet is removed and replaced with another long wire called a guide wire. It is normal for blood to spout out of the needle before the guide wire is inserted. The guide wire is fed through the outer needle into the artery and to the area that requires angiographic study. A fluoroscopic screen that displays a view of the patients vascular system is used to pilot the wire to the correct location. Once it is in position, the needle is removed and a catheter is slid over the length of the guide wire until it to reaches the area of study. The guide wire is removed and the catheter is left in place in preparation for the injection of the contrast medium, or dye. Depending on the type of angiography procedure being performed, the contrast medium is either injected by hand with a syringe or is mechanically injected with an automatic injector connected to the catheter. An automatic injector is used frequently because it is able to propel a large volume of dye very quickly to the angiogram site. The patient is warned that the injection will start, and instructed to remain very still. The injection causes some mild to moderate discomfort. Possible side effects or reactions include headache, dizziness, irregular heartbeat, nausea, warmth, burning sensation, and chest pain, but they usually last only momentarily. To view the area of study from different angles or perspectives, the patient may be asked to change positions several times, and subsequent dye injections may be administered. During any injection, the patient or the camera may move. Throughout the dye injection procedure, x-ray pictures and/or fluoroscopic pictures (or moving x rays) will be taken. Because of the high pressure of arterial blood flow, the dye will dissipate through the patients system quickly, so pictures must be taken in rapid succession. An automatic film changer is used because the manual changing of x-ray plates can eat up valuable time. Once the x rays are complete, the catheter is slowly and carefully removed from the patient. Pressure is applied to the site with a sandbag or other weight for 10-20 minutes in order for clotting to take place and the arterial puncture to reseal itself. A pressure bandage is then applied. Most angiograms follow the general procedures outlined above, but vary slightly depending on the area of the vascular system being studied. A variety of common angiography procedures are outlined below: Cerebral angiography Cerebral angiography is used to detect aneurysms, blood clots, and other vascular irregularities in the brain. The catheter is inserted into the femoral or carotid artery and the injected contrast medium travels through the blood vessels on the brain. Patients frequently experience headache, warmth, or a burning sensation in the head or neck during the injection portion of the procedure. A cerebral angiogram takes two to four hours to complete. Coronary angiography Coronary angiography is administered by a cardiologist with training in radiology or, occasionally, by a radiologist. The arterial puncture is typically given in the femoral artery, and the cardiologist uses a guide wire and catheter to perform a contrast injection and x-ray series on the coronary arteries. The catheter may also be placed in the left ventricle to examine the mitral and aortic valves of the heart. If the cardiologist requires a view of the right ventricle of the heart or of the tricuspid or pulmonic valves, the catheter will be inserted through a large vein and guided into the right ventricle. The catheter also serves the purpose of monitoring blood pressures in these different locations inside the heart. The angiogram procedure takes several hours, depending on the complexity of the procedure. Pulmonary angiography Pulmonary, or lung, angiography is performed to evaluate blood circulation to the lungs. It is also considered the most accurate diagnostic test for detecting a pulmonary embolism. The procedure differs from cerebral and coronary angiograms in that the guide wire and catheter are inserted into a vein instead of an artery, and are guided up through the chambers of the heart and into the pulmonary artery. Throughout the procedure, the patients vital signs are monitored to ensure that the catheter doesnt cause arrhythmias, or irregular heartbeats. The contrast medium is then injected into the pulmonary artery where it circulates through the lung capillaries. The test typically takes up to 90 minutes. Kidney angiography Patients with chronic renal disease or injury can suffer further damage to their kidneys from the contrast medium used in a kidney angiogram, yet they often require the test to evaluate kidney function. These patients should be well-hydrated with a intravenous saline drip before the procedure, and may benefit from available medications (e.g., dopamine) that help to protect the kidney from further injury due to contrast agents. During a kidney angiogram, the guide wire and catheter are inserted into the femoral artery in the groin area and advanced through the abdominal aorta, the main artery in the abdomen, and into the renal arteries. The procedure will take approximately one hour. Fluorescein angiography Fluorescein angiography is used to diagnose retinal problems and circulatory disorders. It is typically conducted as an outpatient procedure. The patients pupils are dilated with eye drops and he rests his chin and forehead against a bracing apparatus to keep it still. Sodium fluorescein dye is then injected with a syringe into a vein in the patients arm. The dye will travel through the patients body and into the blood vessels of the eye. The procedure does not require x rays. Instead, a rapid series of close-up photographs of the patients eyes are taken, one set immediately after the dye is injected, and a second set approximately 20 minutes later once the dye has moved through the patients vascular system. The entire procedure takes up to one hour. Celiac and mesenteric angiography Celiac and mesenteric angiography involves x-ray exploration of the celiac and mesenteric arteries, arterial branches of the abdominal aorta that supply blood to the abdomen and digestive system. The test is commonly used to detect aneurysm, thrombosis, and signs of ischemia in the celiac and mesenteric arteries, and to locate the source of gastrointestinal bleeding. It is also used in the diagnosis of a number of conditions, including portal hypertension, and cirrhosis. The procedure can take up to three hours, depending on the number of blood vessels studied. Splenoportography A splenoportograph is a variation of an angiogram that involves the injection of contrast medium directly into the spleen to view the splenic and portal veins. It is used to diagnose blockages in the splenic vein and portal vein thrombosis and to assess the strength and location of the vascular system prior to liver transplantation. Most angiography procedures are typically paid for by major medical insurance. Patients should check with their individual insurance plans to determine their coverage. Aftercare Risks Because angiography involves puncturing an artery, internal bleeding or hemorrhage are possible complications of the test. As with any invasive procedure, infection of the puncture site or bloodstream is also a risk, but this is rare. A stroke or heart attack may be triggered by an angiogram if blood clots or plaque on the inside of the arterial wall are dislodged by the catheter and form a blockage in the blood vessels or artery. The heart may also become irritated by the movement of the catheter through its chambers during pulmonary and coronary angiography procedures, and arrhythmias may develop. Patients who develop an allergic reaction to the contrast medium used in angiography may experience a variety of symptoms, including swelling, difficulty breathing, heart failure, or a sudden drop in blood pressure. If the patient is aware of the allergy before the test is administered, certain medications can be administered at that time to counteract the reaction. Angiography involves minor exposure to radiation through the x rays and fluoroscopic guidance used in the procedure. Unless the patient is pregnant, or multiple radiological or fluoroscopic studies are required, the small dose of radiation incurred during a single procedure poses little risk. However, multiple studies requiring fluoroscopic exposure that are conducted in a short time period have been known to cause skin necrosis in some individuals. This risk can be minimized by careful monitoring and documentation of cumulative radiation doses administered to these patients. Normal results The results of an angiogram or arteriogram depend on the artery or organ system being examined. Generally, test results should display a normal and unimpeded flow of blood through the vascular system. Fluorescein angiography should result in no leakage of fluorescein dye through the retinal blood vessels. Abnormal results Abnormal results of an angiography may display a restricted blood vessel or arterial blood flow (ischemia) or an irregular placement or location of blood vessels. The results of an angiography vary widely by the type of procedure performed, and should be interpreted and explained to the patient by a trained radiologist. Arteriosclerosis A chronic condition characterized by thickening and hardening of the arteries and the build-up of plaque on the arterial walls. Arteriosclerosis can slow or impair blood circulation. Carotid artery An artery located in the neck. Catheter A long, thin, flexible tube used in angiography to inject contrast material into the arteries. Cirrhosis A condition characterized by the destruction of healthy liver tissue. A cirrhotic liver is scarred and cannot break down the proteins in the bloodstream. Cirrhosis is associated with portal hypertension. Embolism A blood clot, air bubble, or clot of foreign material that travels and blocks the flow of blood in an artery. When blood supply to a tissue or organ is blocked by an embolism, infarction, or death of the tissue the artery feeds, occurs. Without immediate and appropriate treatment, an embolism can be fatal. Femoral artery An artery located in the groin area that is the most frequently accessed site for arterial puncture in angiography. Fluorescein dye An orange dye used to illuminate the blood vessels of the retina in fluorescein angiography. Fluoroscopic screen A fluorescent screen which displays moving x-rays of the body. Fluoroscopy allows the radiologist to visualize the guide wire and catheter he is moving through the patients artery. Guide wire A wire that is inserted into an artery to guides a catheter to a certain location in the body. Iscehmia A lack of normal blood supply to a organ or body part because of blockages or constriction of the blood vessels. Necrosis Cellular or tissue death; skin necrosis may be caused by multiple, consecutive doses of radiation from fluoroscopic or x-ray procedures. Plaque Fatty material that is deposited on the inside of the arterial wall. Portal hypertension A condition caused by cirrhosis of the liver. It is characterized by impaired or reversed blood flow from the portal vein to the liver, an enlarged spleen, and dilated veins in the esophagus and stomach. Portal vein thrombosis The development of a blood clot in the vein that brings blood into the liver. Untreated portal vein thrombosis causes portal hypertension. For Your Information Books * Baum, Stanley, and Michael J. Pentecost, eds. Abrams Angiography. 4th ed. Radiation Protection for Angiography Procedure. Radiation Protection for Angiography Procedure. Fluoroscopic procedure produces the greatest patient radiation exposure rate in diagnostic radiology. Therefore the radiation protection in fluoroscopy is very important. Several feature and techniques in fluoroscopy are designed for protection to the patient during fluoroscopic procedure. a) Protection to Patient * A dead-man switch is a device (switch) constructed so that a circuit closing contact can only be maintained by continuous pressure on the switch by the operator. Therefore, when the machine is turned on by any means, whether by the push button at the control panel, or by the foot pedal, this switch must be held in for the machine to remain on. * The on-time of the fluoroscopic tube must be controlled by a timing device, and must end alarm when the exposure exceeds 5 minutes. An audible signal must alert the user to the completion of the preset on time. This signal will remain on until the timing device is reset. * The X-ray tube used for fluoroscopic must not produce X-rays unless a barrier is in position to intercept the entire cross-section of the useful beam. The fluoroscopic imaging assembly must be provided with shielding sufficient that the scatter radiation from the useful beam is minimized. * Protective barriers of at least 0.25 mm lead equivalency must be used to attenuate scatter radiation above the tabletop. This shielding does not replace the lead garments worn by personnel. Scattered radiation under the table must be attenuated by at least 0.25 mm lead equivalency shielding. * Additionally, most c-arm fluoroscopes have a warning beeper or light that activate when the beam is on, some have both. Never inactivate any warning devices, and keep ones foot off the foot pedal whenever possible. * Methods of limiting radiation exposure include: o making certain that the fluoroscopy unit is functioning properly through routine maintenance, o limiting fluoroscopic exposure time, o reducing fields of exposure through collimation, o keeping the X-ray source under the table by avoiding cross-table lateral visualization when possible, and o bringing the image intensifier down close to the patient b) Protection to personnel There are therefore three basic ways to minimize dose: * Reduce time of exposure * Use the inverse square law-doubling your distance away quarter your exposure * Use shielding by barrier These basics known as Cardinal Principle which is important to achieved ALARA. i) Time Radiation dose is directly proportional to the time, those by doubling the radiation time the dose is doubled and by having the radiation time the doses halved. Many factors impact the on time of a fluoroscopic procedure. The exposure time is related to radiation exposure and exposure rate (exposure per unit time) as follows: Exposure time = Exposure/Exposure rate Exposure = Exposure rate x time The algebraic expressions simply imply that if the exposure time is kept short, then the resulting dose to the individual is small. Method of reducing exposure time include meticulous advanced planning of the procedure, judicious use of contrast enhancement, appropriate positioning of the patient, orientation of the fluoroscope unit prior to beginning the procedure. ii) Distance The second radiation protection action relates to the distance between the source of radiation and the exposed individual. The exposure to the individual decreases inversely as the square of the distance. This is known as the inverse square law, which is stated mathematically as: where I is the intensity of radiation and d is the distance between the radiation source and the exposed individual. For example, when the distance is doubled the exposure is reduced by a factor of four. In mobile radiography, where there is no fixed protective control booth, the technologist should remain at least 2 m from the patient, the x-ray tube, and the primary beam during the exposure. In this respect, the ICRP (1982), as well as the NCRP (1989a), recommended that the length of the exposure cord on mobile radiographic units be at least 2 m long. Another important consideration with respect to distance relates to the source-to-image receptor distance (SID). The appropriate SIDs for various examinations must always be maintained because an incorrect SID could mean a second exposure to the patient. Long SID results in less divergent beam and thus decreases the concentration of photons in the patients. Short SID results in the reverse action and increases the patient dose. Hence the longest possible SID should be employed in examinations. However, if a greater than standard SID is used then greater intensity of radiation would be required to produce the same film density. Therefore it is recommended that only standard SIDs should be used. iii) Shielding Shielding procedure the most utilitarian results in the reduction of staff dose as there are times when the procedure list simply must function in close proximity, even directly cines fluoroscopy. In these circumstances there simply is no substitute for the best modern flexible lead gloves, lead glasses, lightweight lead apron and lead lined thyroid shield available. Appropriate shielding is mandatory for the safe use of ionizing radiation for medical imaging. Other method of shielding includes beam collimation, protective drapes and panels. Shielding of occupational workers can be achieved by following methods: * Personnel should remain in the radiation environment only when necessary (step behind the control booth, or leave the room when practical) * The distance between the personnel and the patient should be maximized when practical as the intensity of radiation decreases as the square of distance (inverse square law). * Shielding apparel should be used as and when necessary which comprise of lead aprons, eye glasses with side shields, hand gloves and thyroid shields. Lead aprons are shielding apparel recommended for use by radiation workers. These are classified as a secondary barrier to the effects of ionizing radiation. These aprons protect an individual only from secondary (scattered) radiation, not the primary beam. The thickness of lead in the protective apparel determines the protection it provides. It is known that 0.25 mm lead thickness attenuates 66% of the beam at 75kVp and 1mm attenuates 99% of the beam at same kVp. It is recommended that for general purpose radiography the minimum thickness of lead equivalent in the protective apparel should be 0.5mm. It is recommended that women radiation workers should wear a customized lead apron that reaches below mid thigh level and wraps completely around the pelvis. This would eliminate an accidental exposure to a concept us. Other protective apparel included eye glasses with side shields, thyroid shields and hand gloves. The minimum protective lead equivalents in hand gloves and thyroid shields should be 0.5mm. Lead lined glass and thyroid shield likewise reduce 90% of the exposure to the eyes and thyroid respectively. Lead lined gloves reduce radiation exposure to the hands; however they are no substitute for strict observation of appropriate fluoroscopic hygiene. Gloves should be considered as an effective means of reducing scatter radiation only. 2. State five clinical indications for the patient undergo the angiography procedure. 3. Explain the patient care management before, during and after the procedure Before a procedure: * Patients undergoing an angiogram are advised to stop eating and drinking eight hours prior to the procedure. * They must remove all jewelry before the procedure and change into a hospital gown. * If the arterial puncture is to be made in the armpit or groin area, shaving may be required. * A sedative may be administered to relax the patient for the procedure. * An IV line will also be inserted into a vein in the patients arm before the procedure begins in case medication or blood products are required during the angiogram. * Be aware of and follow all Local Rules and protocols * Prior to the angiography procedure, patients will be briefed on the details of the test, the benefits and risks, and the possible complications involved, and asked to sign an informed consent form. * Ensure that all exposures are justified and there is informed consent * Check patient identity * Position patient comfortably flat, with arm above head where possible * Ensure all members of staff in room are wearing suitable. For operations this should be lead glasses, thyroid collar and wrap-around lead apron * Check all staff are wearing radiation monitors correctly * Use all available lead shielding appropriately sited * Position table before screening * Keep tube current as low as possible and kVp as high as possible for cardiac studies, 60 – 90 kV is appropriate * Keep x ray tube at maximum and image intensifier / receptor at minimum distance from patient * Check all staff are as far away as possible in their role * Use dose reduction programmers when possible * Perform acquisitions on full inspiration where possible * Collimate closely to area of interest * Prolonged procedures: reduce dose to the irradiated skin eg. Change beam angulations * Minimize fluoroscopy time, high dose rate time and no of acquisitions * Remember software features, such as replay fluoro to minimize dose * Dont over use geometric magnification * Remove grid for small patients or when image intensifier / detector cannot be placed close to patient * Check and record screening time and DAP at the end of the case and review against the DRL. During the procedure: * The radiologic technologist will position you on the exam table. A radiologist a physician who specializes in the diagnostic interpretation of medical images will administer a local anesthetic and then make a small nick in your skin so that a thin catheter can be inserted into an artery or vein. The catheter is a flexible, hollow tube about the size of a strand of spaghetti. It usually is inserted into an artery in your groin, although in some cases your arm or another site will be selected for the catheter. * The radiologist will ease the catheter into the artery or vein and gently guide it to the area under investigation. The radiologist will be able to watch the movement of the catheter on a fluoroscope, which is an x-ray unit combined with a television monitor. * When the catheter reaches the area under study, the contrast agent will be injected through the catheter. By watching the fluoroscope screen, the radiologist will be able to see the outline of your blood vessels and identify any blockages or other irregularities. * Angiography procedures can range in time from less than an hour to three hours or more. It is important that you relax and remain as still as possible during the examination. The radiologic technologist and radiologist will stay in the room with you throughout the procedure. If you experience any difficulty, let them know. * Angiography also can be performed using magnetic resonance instead of x-rays to produce images of the blood vessels; this procedure is known as magnetic resonance angiography (MRA) or magnetic resonance venography (MRV). After the procedure: * Because life-threatening internal bleeding is a possible complication of an arterial puncture, an overnight stay in the hospital is sometimes recommended following an angiography procedure, particularly with cerebral and coronary angiograms. * If the procedure is performed on an outpatient basis, the patient is typically kept under close observation for a period of at six to 12 hours before being released. * If the arterial puncture was performed in the femoral artery, the patient will be instructed to keep his leg straight and relatively immobile during the observation period. * The patients blood pressure and vital signs will be monitored and the puncture site observed closely. Pain medication may be prescribed if the patient is experiencing discomfort from the puncture, and a cold pack is applied to the site to reduce swelling. It is normal for the puncture site to be sore and bruised for several weeks. * The patient may also develop a hematoma, a hard mass created by the blood vessels broken during the procedure. Hematomas should be watched carefully, as they may indicate continued bleeding of the arterial puncture site. * Angiography patients are also advised to enjoy two to three days of rest and relaxation after the procedure in order to avoid placing any undue stress on the arterial puncture. Patients who experience continued bleeding or abnormal swelling of the puncture site, sudden dizziness, or chest pains in the days following an angiography procedure should seek medical attention immediately. * Patients undergoing a fluorescein angiography should not drive or expose their eyes to direct sunlight for 12 hours following the procedure. 4. Identify the type of contrast medium, the dose and delivering technique in angiography procedure. * Reducing radiation doses to the patient also generally reduces doses to the medical personnel. Â · Angiography procedure is using fluoroscopy imaging technique which is a real-time imaging technique. 5. List down the catheters and guide wires inclusive of size, shape and the hole type that are used in angiography procedures. The use of lead gloves during procedures is unusual as they are cumbersome and difficult to work in. The automatic brightness control will increase the exposure to go through two layers and one only protects the hand, so if they are going to be used a programme that sets the radiation factors rather than allowing adjustment may be appropriate. In practice, with careful collimation and attenuation to detail it should not necessary for the operators hand to be in the primary beam and only close to it for short periods. While doing catheterization, radiologist should do it behind the lead glass viewer which consists of lead equivalent glass of 0.25mm thickness. Geometric consideration is one of the important things in angiography because source of exposure to personnel is mainly from scattered radiation from the patient. So, it is important to minimize the amount of scattered radiation to personnel. This can be achieved by geometric consideration involving the x-ray tube, patient and image intensifier. The image intensifier should be as close as possible to patient to minimize the amount of scattered radiation hitting personnel. Because in angiography room is sterile for all things, personnel such as radiologist, nurses, radiographer or student should wear shoes which are prepared only. Make sure that film badges always outside personnel body to measure the dose receive to the personnel. The most important thing to remember is that all individuals should be fully trained and learned to be responsible for radiation safety. Involvement of a radiation expert is essential and is particularly useful in equipment specification, assessment and quality assurance, but also in the formulation of Local Rules. Technique Reduces Physician Radiation Exposure During Angiography Current technique requires that physicians performing radiation procedures wear lead gowns. The new technique involves use of a body length floor mounted lead plastic panel to protect to physicians as they monitor patients angiograms and control exam table movement. An extension bar allows the physician to remain safely behind the shield and still retain table control for panning. In the study, researchers recorded radiation exposure to various parts of a physicians body during 25 coronary angiography procedures and compared those results with radiation exposure during angiography on 25 patients using conventional radiation protection. A lead apron, thyroid shield, eyeglasses and facemask were used in both techniques, but a ceiling mounted shield was used in the conventional technique. The researchers placed radiation badges outside and inside the facemask; outside and inside the thyroid shield; on the right and left arm; outside and inside the lead apron; and on the right and left leg. The new equipment resulted in a 90 percent reduction in radiation exposure to the physicians head, arms, and legs. Exposure of the thyroid and torso was minimal with both techniques. Enhanced physician radiation protection during coronary angiography is readily achievable with this new technique, said Martin Magram, M.D., of the University of Maryland Medical Center in Baltimore, Md. Dr. Magram presented the study results on May 3 at the American Roentgen Ray Society Annual Meeting in Vancouver, British Columbia. Dr. Magram pointed out that by freeing physicians from the need to wear lead gowns, the new technique could preserve their ability to benefit patients. It may extend by years their ability to apply the skills they have developed over long careers of serving patients, noted Dr. Magram. New methods of radiation protection must parallel the development of new radiation techniques, added Dr. Magram. The key is to limit medical workers radiation exposure with effective and easy-to-use techniques, and the use of this extension bar and lead plastic shield may be such a technique. Definition Angiography is the x-ray study of the blood vessels. An angiogram uses a radiopaque substance, or dye, to make the blood vessels visible under x ray. Arteriography is a type of angiography that involves the study of the arteries. Purpose Angiography is used to detect abnormalities or blockages in the blood vessels (called occlusions) throughout the circulatory system and in some organs. The procedure is commonly used to identify atherosclerosis; to diagnose heart disease; to evaluate kidney function and detect kidney cysts or tumors; to detect an aneurysm (an abnormal bulge of an artery that can rupture leading to hemorrhage), tumor, blood clot, or arteriovenous malformations (abnormals tangles of arteries and veins) in the brain; and to diagnose problems with the retina of the eye. It is also used to give surgeons an accurate map of the heart prior to open-heart surgery, or of the brain prior to neurosurgery. Precautions Patients with kidney disease or injury may suffer further kidney damage from the contrast mediums used for angiography. Patients who have blood clotting problems, have a known allergy to contrast mediums, or are allergic to iodine, a component of some contrast mediums, may also not be suitable candidates for an angiography procedure. Because x rays carry risks of ionizing radiation exposure to the fetus, pregnant women are also advised to avoid this procedure. Description Angiography is usually performed at a hospital by a trained radiologist and assisting technician or nurse. It takes place in an x-ray or fluoroscopy suite, and for most types of angiograms, the patients vital signs will be monitored throughout the procedure. Angiography requires the injection of a contrast dye that makes the blood vessels visible to x ray. The dye is injected through a procedure known as arterial puncture. The puncture is usually made in the groin area, armpit, inside elbow, or neck. The site is cleaned with an antiseptic agent and injected with a local anesthetic. First, a small incision is made in the skin to help the needle pass. A needle containing an inner wire called a stylet is inserted through the skin into the artery. When the radiologist has punctured the artery with the needle, the stylet is removed and replaced with another long wire called a guide wire. It is normal for blood to spout out of the needle before the guide wire is inserted. The guide wire is fed through the outer needle into the artery and to the area that requires angiographic study. A fluoroscopic screen that displays a view of the patients vascular system is used to pilot the wire to the correct location. Once it is in position, the needle is removed and a catheter is slid over the length of the guide wire until it to reaches the area of study. The guide wire is removed and the catheter is left in place in preparation for the injection of the contrast medium, or dye. Depending on the type of angiography procedure being performed, the contrast medium is either injected by hand with a syringe or is mechanically injected with an automatic injector connected to the catheter. An automatic injector is used frequently because it is able to propel a large volume of dye very quickly to the angiogram site. The patient is warned that the injection will start, and instructed to remain very still. The injection causes some mild to moderate discomfort. Possible side effects or reactions include headache, dizziness, irregular heartbeat, nausea, warmth, burning sensation, and chest pain, but they usually last only momentarily. To view the area of study from different angles or perspectives, the patient may be asked to change positions several times, and subsequent dye injections may be administered. During any injection, the patient or the camera may move. Throughout the dye injection procedure, x-ray pictures and/or fluoroscopic pictures (or moving x rays) will be taken. Because of the high pressure of arterial blood flow, the dye will dissipate through the patients system quickly, so pictures must be taken in rapid succession. An automatic film changer is used because the manual changing of x-ray plates can eat up valuable time. Once the x rays are complete, the catheter is slowly and carefully removed from the patient. Pressure is applied to the site with a sandbag or other weight for 10-20 minutes in order for clotting to take place and the arterial puncture to reseal itself. A pressure bandage is then applied. Most angiograms follow the general procedures outlined above, but vary slightly depending on the area of the vascular system being studied. A variety of common angiography procedures are outlined below: Cerebral angiography Cerebral angiography is used to detect aneurysms, blood clots, and other vascular irregularities in the brain. The catheter is inserted into the femoral or carotid artery and the injected contrast medium travels through the blood vessels on the brain. Patients frequently experience headache, warmth, or a burning sensation in the head or neck during the injection portion of the procedure. A cerebral angiogram takes two to four hours to complete. Coronary angiography Coronary angiography is administered by a cardiologist with training in radiology or, occasionally, by a radiologist. The arterial puncture is typically given in the femoral artery, and the cardiologist uses a guide wire and catheter to perform a contrast injection and x-ray series on the coronary arteries. The catheter may also be placed in the left ventricle to examine the mitral and aortic valves of the heart. If the cardiologist requires a view of the right ventricle of the heart or of the tricuspid or pulmonic valves, the catheter will be inserted through a large vein and guided into the right ventricle. The catheter also serves the purpose of monitoring blood pressures in these different locations inside the heart. The angiogram procedure takes several hours, depending on the complexity of the procedure. Pulmonary angiography Pulmonary, or lung, angiography is performed to evaluate blood circulation to the lungs. It is also considered the most accurate diagnostic test for detecting a pulmonary embolism. The procedure differs from cerebral and coronary angiograms in that the guide wire and catheter are inserted into a vein instead of an artery, and are guided up through the chambers of the heart and into the pulmonary artery. Throughout the procedure, the patients vital signs are monitored to ensure that the catheter doesnt cause arrhythmias, or irregular heartbeats. The contrast medium is then injected into the pulmonary artery where it circulates through the lung capillaries. The test typically takes up to 90 minutes. Kidney angiography Patients with chronic renal disease or injury can suffer further damage to their kidneys from the contrast medium used in a kidney angiogram, yet they often require the test to evaluate kidney function. These patients should be well-hydrated with a intravenous saline drip before the procedure, and may benefit from available medications (e.g., dopamine) that help to protect the kidney from further injury due to contrast agents. During a kidney angiogram, the guide wire and catheter are inserted into the femoral artery in the groin area and advanced through the abdominal aorta, the main artery in the abdomen, and into the renal arteries. The procedure will take approximately one hour. Fluorescein angiography Fluorescein angiography is used to diagnose retinal problems and circulatory disorders. It is typically conducted as an outpatient procedure. The patients pupils are dilated with eye drops and he rests his chin and forehead against a bracing apparatus to keep it still. Sodium fluorescein dye is then injected with a syringe into a vein in the patients arm. The dye will travel through the patients body and into the blood vessels of the eye. The procedure does not require x rays. Instead, a rapid series of close-up photographs of the patients eyes are taken, one set immediately after the dye is injected, and a second set approximately 20 minutes later once the dye has moved through the patients vascular system. The entire procedure takes up to one hour. Celiac and mesenteric angiography Celiac and mesenteric angiography involves x-ray exploration of the celiac and mesenteric arteries, arterial branches of the abdominal aorta that supply blood to the abdomen and digestive system. The test is commonly used to detect aneurysm, thrombosis, and signs of ischemia in the celiac and mesenteric arteries, and to locate the source of gastrointestinal bleeding. It is also used in the diagnosis of a number of conditions, including portal hypertension, and cirrhosis. The procedure can take up to three hours, depending on the number of blood vessels studied. Splenoportography A splenoportograph is a variation of an angiogram that involves the injection of contrast medium directly into the spleen to view the splenic and portal veins. It is used to diagnose blockages in the splenic vein and portal vein thrombosis and to assess the strength and location of the vascular system prior to liver transplantation. Most angiography procedures are typically paid for by major medical insurance. Patients should check with their individual insurance plans to determine their coverage. Aftercare Risks Because angiography involves puncturing an artery, internal bleeding or hemorrhage are possible complications of the test. As with any invasive procedure, infection of the puncture site or bloodstream is also a risk, but this is rare. A stroke or heart attack may be triggered by an angiogram if blood clots or plaque on the inside of the arterial wall are dislodged by the catheter and form a blockage in the blood vessels or artery. The heart may also become irritated by the movement of the catheter through its chambers during pulmonary and coronary angiography procedures, and arrhythmias may develop. Patients who develop an allergic reaction to the contrast medium used in angiography may experience a variety of symptoms, including swelling, difficulty breathing, heart failure, or a sudden drop in blood pressure. If the patient is aware of the allergy before the test is administered, certain medications can be administered at that time to counteract the reaction. Angiography involves minor exposure to radiation through the x rays and fluoroscopic guidance used in the procedure. Unless the patient is pregnant, or multiple radiological or fluoroscopic studies are required, the small dose of radiation incurred during a single procedure poses little risk. However, multiple studies requiring fluoroscopic exposure that are conducted in a short time period have been known to cause skin necrosis in some individuals. This risk can be minimized by careful monitoring and documentation of cumulative radiation doses administered to these patients. Normal results The results of an angiogram or arteriogram depend on the artery or organ system being examined. Generally, test results should display a normal and unimpeded flow of blood through the vascular system. Fluorescein angiography should result in no leakage of fluorescein dye through the retinal blood vessels. Abnormal results Abnormal results of an angiography may display a restricted blood vessel or arterial blood flow (ischemia) or an irregular placement or location of blood vessels. The results of an angiography vary widely by the type of procedure performed, and should be interpreted and explained to the patient by a trained radiologist. Arteriosclerosis A chronic condition characterized by thickening and hardening of the arteries and the build-up of plaque on the arterial walls. Arteriosclerosis can slow or impair blood circulation. Carotid artery An artery located in the neck. Catheter A long, thin, flexible tube used in angiography to inject contrast material into the arteries. Cirrhosis A condition characterized by the destruction of healthy liver tissue. A cirrhotic liver is scarred and cannot break down the proteins in the bloodstream. Cirrhosis is associated with portal hypertension. Embolism A blood clot, air bubble, or clot of foreign material that travels and blocks the flow of blood in an artery. When blood supply to a tissue or organ is blocked by an embolism, infarction, or death of the tissue the artery feeds, occurs. Without immediate and appropriate treatment, an embolism can be fatal. Femoral artery An artery located in the groin area that is the most frequently accessed site for arterial puncture in angiography. Fluorescein dye An orange dye used to illuminate the blood vessels of the retina in fluorescein angiography. Fluoroscopic screen A fluorescent screen which displays moving x-rays of the body. Fluoroscopy allows the radiologist to visualize the guide wire and catheter he is moving through the patients artery. Guide wire A wire that is inserted into an artery to guides a catheter to a certain location in the body. Iscehmia A lack of normal blood supply to a organ or body part because of blockages or constriction of the blood vessels. Necrosis Cellular or tissue death; skin necrosis may be caused by multiple, consecutive doses of radiation from fluoroscopic or x-ray procedures. Plaque Fatty material that is deposited on the inside of the arterial wall. Portal hypertension A condition caused by cirrhosis of the liver. It is characterized by impaired or reversed blood flow from the portal vein to the liver, an enlarged spleen, and dilated veins in the esophagus and stomach. Portal vein thrombosis The development of a blood clot in the vein that brings blood into the liver. Untreated portal vein thrombosis causes portal hypertension. For Your Information Books * Baum, Stanley, and Michael J. Pentecost, eds. Abrams Angiography. 4th ed.