Rational Thinking Essays - Internalism And Externalism,

Rational Thinking The Change in Rational Thinking Before 1750 The idea of rational thinking has been debated ever since the beginning of human existence. As humans we base what we think on what we know, during the 1600's if a person was black than they must have been inferior. This thinking seemed rational to the people of this period because they didn't know any better. The concept of rationality throughout time has always been a matter of perspective. If you are taught from birth that black people are inferior and grow-up with this idea in your head than you have no other basis for how you perceive someone with a skin color other than yourself. If we think about it, before 1650 belief was all that was needed when there was an argument about religion. People listened to what the Pope had to say because he was thought to be an extenuation of God, and whatever he preached was obviously true. Today we look at that behavior and laugh, if even half of the rationalism that was applied 350 years ago was applied today in some religions, no one would enter into them. It is good to know that through research by men like Aristotle, who determined that the earth is round, someone like Copernicus can learn that the earth is not only orbiting like the stars but it is orbiting the biggest planet the sun. But this knowledge came with a price; the Pope who was believed infallible did not approve of any of these radical nee findings, everything that these men were saying went right against the beliefs of the Catholic Church. A couple of hundred years earlier this new thinking would have had a lot harder time getting off the ground because there was no fast, economical way to spread the information. That was until the invention of the printing press, now the Pope had to deal with the problem that these ideas could be printed and distributed in a fast manner. With society now having the ability to gain access to new information, people began to question the rationalism of the Roman Catholic Church. Not to mention at this same time the Pope and the Church now had to deal with the outrage from Martin Luther who was causing all sort of problems up at Wittenberg. He was focused on taking a majority of the Church's ideas and thinking about them in a rational way not mystical. To him the Church had an uncanny way of always being able to manipulate the meaning of the word to suit it's best interest. Luther decided that a lot of the Church's ideas were hogwash, so he decided to post a critique of ninety-five changes to the Roman Catholic Church's teachings. In the end he also paid the ultimate price, his life. In the years approaching 1700 society began to look at the fact that there were other ways of thinking, this set off a rash ideologies from scientists, philosophers and even people within religions to approach thinking with a more defined, rational point of view. Even when it came to wealth did the event of rational thinking take place. For centuries there have been many various ideas for what the meaning of wealth is. From it being bullion, commodities, the market and finally today the concept of capitalism. It is funny to think that capitalism may not even be the true idea about wealth, but behind it all is the progression of rational thinking and ideas. It must have been interesting to be alive for the early years to experience ideas that seemed far away but seemed rational. In addition these intelligent people finally had findings to back up what they were saying.

How to Get Your CDL in Pennsylvania and Rhode Island

How to Get Your CDL in Pennsylvania and Rhode Island This article is useful for anyone who wants to get a CDL in Pennsylvania and Rhode Island. If you want to learn about earning a CDL at other states, we have put together a comprehensive guide on how to get a commercial driver’s license in every state of the country. PennsylvaniaIn Pennsylvania, you must have a CDL to operate:Any single vehicle with a GVWR of 26,001+ poundsA combination vehicle with a GCWR of 26,001+ pounds, if  the GVWR of the vehicle(s) being towed is more than  10,000 poundsA vehicle designed to transport 16+ passengers (including the driver)A school bus designed to transport 11+ passengers (including the drive)Any size vehicle requiring hazardous material placards or carrying material listed as a select agent or toxinIn order to obtain a CDL, you must take a knowledge test and a skills test.Knowledge TestAll applicants must pass a knowledge test required for the class of license, restriction, and endorsements they wish to possess. A general knowledge te st for the Class, a or Class B and C license must be successfully completed by all CDL applicants.You  must wait 15 days after passing the knowledge test to take the skills test.Skills TestAfter passing the appropriate knowledge tests, you  must then take the skills test for the class and type of vehicle you intend to drive.   Included on this exam are a  pre-trip inspection, a test of basic vehicle control, and a test in on-road driving.After passing your knowledge and skills tests, you will be given  a camera card to  take to any PennDOT Photo License Center. There, you will have your picture taken and be  issued your CDL after paying all  licensing fees.Rhode IslandYou must have a CDL to operate:Any single vehicle with a GVWR of 26,001+ poundsA combination vehicle with a GCWR of 26,001+ pounds, if  the GVWR of the vehicle(s) being towed is more than  10,000 poundsA vehicle designed to transport 16+ passengers (including the driver)Any size vehicle requiring  hazardous material placards or carrying material listed as a select agent or toxin in 42 CFR part 73.In order to obtain a CDL, you must take a knowledge test and a skills test.Knowledge TestYou must take one or more knowledge tests depending the license  class and endorsements you need.All applicants must take the general knowledge test, taken by all applicants.All bus driver applicants must take the passenger transport test.If you want to drive a school bus, you must pass the school bus test.If driving a  vehicle with air brakes, including air over hydraulic brakes,   you must take the air brakes test.If you want to drive combination vehicles, you must take the combination vehicles test.If you want to haul hazardous materials as defined in 49 CFR 383.5, you must take  the hazardous materials test. You must also pass a background check.If  you want to haul any liquid or gaseous materials in tank(s)  with an  individual rated capacity of 119+ gallons and an aggregate r ated capacity of 1,000+ gallons, you must take the tank vehicle test.If you want to pull double or triple trailers, you must take  he doubles/triples test.After you pass your required knowledge tests, you must then take your CDL skills tests.Skills TestAfter passing the appropriate knowledge tests, you  must then take the skills test for the class and type of vehicle you intend to drive.   Included on this exam are a  pre-trip inspection, a test of basic vehicle control, and a test in on-road driving.When you arrive for these tests, you must present your Rhode Island driver’s license and your CDL permit (obtained after passing the appropriate knowledge tests).

List of Halogens (Element Groups)

List of Halogens (Element Groups) The halogen elements are located in group VIIA of the periodic table, which is the second-to-last column of the chart. This is a list of elements that belong to the halogen group and the properties that they share in common: Types of Halogens Depending on who you ask, there are either 5 or 6 halogens. Fluorine, chlorine, bromine, iodine, and astatine definitely are halogens. Element 117, which has the placeholder name of ununseptium, might have some properties in common with the other elements. Even though it is in the same column or group of the periodic table with the other halogens, most scientists believe element 117 will behave more like a metalloid. So little of it has been produced, its a matter of prediction, not empirical data. FluorineChlorineBromineIodineAstatineTennessine (might behave as a halogen, at least in some respects) Halogen Properties These elements share some common properties that distinguish them from other elements on the periodic table. They are highly reactive nonmetals.Atoms of belonging to the halogen group have 7 electrons in their outermost (valence) shell. These atoms need one more electron in order to have a stable octet.Halogens are highly electronegative, with high electron affinities.The melting and boiling points of the halogens increase as you increase atomic number (as you move down the periodic table).The elements change their state of matter at room temperature and pressure as you increase atomic number. Fluorine and chlorine are gases. Bromine is a liquid element. Iodine is a solid. Scientists predict tennessine will be a solid at room temperature.

Safegurads and Controls Essay Example | Topics and Well Written Essays - 500 words

Safegurads and Controls - Essay Example The used book store envision to promote literacy through their funding for education improvement programs by buying books that people do not want, find buyers and fund the proceeds for social cause. Used books are usually collected through campus collection from universities and colleges and from donation initiatives and discard of Libraries. Online services enables the store to distribute used books to a wide range of people globally, nationally and locally, who are in need of free books in underdeveloped countries. Alans used book store gives importance to save million of tonnes of paper waste for recycling rather than using it for landfills. The book store also envisages collecting voluntary funds from customers at exit point to fund reforestation programs and renewable energy credits (Profits with Purpose: Better World Books). Books should be handled with care while arranging them in shelves and moving it to make place for new arrivals. The dust jackets usually get damaged when moving books. Further books should be stored in a systematic manner to avoid theft and to locate books quickly. Books have to be categorized and numbered and stocks should be taken at regular intervals to keep a check on the number of sold items and the number of new arrivals. Proper accounting with details of the book will enable the business to identify books that sell fast and books that do not sell quickly. Books should not be stacked in the shelves; instead it should be placed in a stand up position. This reduces damage to books and offers ease to handle books and prevent the probable damage while taking a book from the bottom of a stacked row. Books should always be placed on the shelves. Books should not be place on the floor since it may contact moisture. Books will get faded and pages will turn yellow if it is exposed to d irect sunlight. Alans used book store proposes to manage risk by purchasing books from users that are mostly sought

A social or cultural phenomenon or aspect of Chinese contemporary Research Paper

A social or cultural phenomenon or aspect of Chinese contemporary society (since 1949) - Research Paper Example My focus will remain largely on the effects and defects of these past and present trends urbanization and village-to-city migration defection. In this context, I will also give particular focus upon the relatively new research done on the position and plight of migrant women in the social structure of the modern, urbanized, industrial China, in broad reference to the central issue of migration. My topic will refer particularly to the works of contemporary urban and social theorists like Martin King Whyte, Wu Jieh-Min, Arianne M. Gaetano and Tamara Acka, among others. I will also consult authoritative government demographic reports and journals to expand the purview of my research and present a comprehensive analysis of the same. Urban-Rural Relations: A Brief Look into the Past The Maoist revolution of China, spanning the 1950s, led by the dynamic leader Mao Zedong, as well as the related economic reforms of 1966-78, had aimed to create a society of equals replacing a dense capitalis t system of greed, corruption and exploitation. One the iconic and historically significant socialist uprisings, it had ventured to establish a communist and ‘egalitarian social order’(Whyte 2010). There existed, however a large gap between theory and reality. Instead, of stabilizing and equalizing the various social strata by creating an economic and cultural balance of sorts, the Great Proletarian Cultural Revolution deepened the gulf between the social classes and created a kind of politicized ‘serfdom’ that kept China away from an ideal communist reconfiguration of the society. (Whyte 2010) Migration and Intra-social Disparities The post-Mao era saw an unprecedented influx of rural migrants to the rapidly developing cities and urban centers of flourishing business, creating a cheap labor force. This rural to urban defection of poor Chinese laborers, especially during the 1980s, can be cited as the most extensive labor flow in the history of the world (Z hao 1999) This proved to be both an economic blessing as well as an indicator of social upheaval. The Rural migration to the urban area of China has been the focus of several social, cultural as well as demographic and anthropological studies. In 1992, records indicate that a staggering 150,000 people were stranded in the railway stations of the Sichuan and Hunan provinces during the ‘Spring Festival Migration’. (Bakken 1998) Laborers from flooded and poverty-stricken rural regions also defected for shelter and jobs to Shanghai, Fujian or other wealthy cities. Under the strict social and political system of hukou or householder registration, they existed mainly as second-class citizens, even outcasts, as Wu Jieh-min pertinently points out in her essay â€Å"Rural Migrant Workers and China’s Differential Citizenship† (2010). Due to the government restriction on rural to urban migration, a deep economic disparity developed between the two. As a result, a tre nd of added incentives attracted rural migrants illegally to the large industrial cities. While the labor source was fully utilized by the greedy and profit driven industries, factories, conglomerates and corporations, however, the socio-cultural history as well as economic and political evidence suggest systematic marginalization. The differential system of perception is a sad reality in the lives of the Chinese migrant families. Case in point, the unequal system of hukou

Inotropes, Vasopressors and Vasodilators

Inotropes, Vasopressors and Vasodilators Suruchi Hasija, Jatin Narula ,Vandana Maravi. ADRENERGIC RECEPTORS AND SIGNALING PATHWAYS The main control over cardiac contractility is provided by the ÃŽ ²Ã¢â‚¬â€œadrenergic signaling pathways and that over the vascular tone by both ÃŽ ±- and ÃŽ ²Ã¢â‚¬â€œadrenergic pathways. The ÃŽ ± and ÃŽ ² receptors are stimulated by catecholamines circulating in the bloodstream and those released locally from the adrenergic nerve endings. The two main subtypes of ÃŽ ²Ã¢â‚¬â€œadrenergic receptors (ÃŽ ²Ã¢â‚¬â€œARs) in the cardiovascular system are the ÃŽ ²1 and ÃŽ ²2 subtypes. Myocardial ÃŽ ²1 and ÃŽ ²2-AR stimulation leads to increased contractility, whereas vascular ÃŽ ²2-AR stimulation induces vascular smooth muscle relaxation. Drug binding to myocardial ÃŽ ²Ã¢â‚¬â€œARs activates stimulatory G protein. This leads to activation of the enzyme adenylate cyclase that catalyzes the conversion of ATP to cAMP. A cascade of intracellular reactions finally leads to the physiological effect of increased myocardial contraction or vasodilation. The ÃŽ ±Ã¢â‚¬â€œadrenergic receptors (ÃŽ ±Ã¢â‚¬â€œARs) are further classified as ÃŽ ±1 and ÃŽ ±2 subtypes. ÃŽ ±1-AR on vascular smooth muscles are the main mediators of vasoconstriction. ÃŽ ±2-AR on the neurons function in a negative feedback loop to control ÃŽ ±-adrenergic vasoconstriction. Stimulation of ÃŽ ±1-AR coupled to G protein activates phospholipase C which in turn raises intracellular Ca+2. Stimulation of ÃŽ ±2-AR coupled to inhibitory G protein inhibits adenylate cyclase, thereby lowering intracellular Ca+2. INOTROPES Inotropy or contractility is the intrinsic property of the cardiac myofibril. It defines the amount of work that the heart can perform at a given load. Contractility is primarily determined by the availability of intracellular calcium. Depolarization of the cardiac myofibril leads to the entry of a small amount of Ca+2 into the cell which triggers the release of additional Ca+2 from intracellular storage sites (sarcoplasmic reticulum). The binding of Ca+2 to troponin, displacement of tropomyosin from the binding site on actin and formation of actin-myosin crossbridges eventually leads to contraction of the myofibril. All inotropic agents act by increasing intracellular calcium. Catecholamines, phosphodiesterase inhibitors and calcium sensitizers are the broad classes of available inotropic agents. Catecholamines Catecholamines comprise the major type of available inotropic agents. Their chemical structure includes a catechol ring, catechol hydroxyl groups and variable side chains. Endogenous(present naturally in the body) catecholamines include epinephrine, norepinephrine and dopamine, and synthetic catecholamines include isoprenaline, dobutamine, dopexamine and fenoldopam. Besides acting directly on adrenergic receptors, some catecholamines may act indirectly by releasing or inhibiting reuptake of norepinephrine at the nerve terminal or by metabolism to form norepinephrine. Table 1: Site and mechanism of action of sympathomimetics Table 2: Haemodynamic effects of catecholamines and phosphodiesterase inhibitors CO=cardiac output, dp/dt=force of myocardial contraction(change in pressure/time), HR=heart rate, SVR=systemic vascular resistance, PVR=pulmonary vascular resistance, PCWP=pulmonary capillary wedge pressure, MVO2=myocardial oxygen consumption Modified from Lehmann A, Boldt J: New pharmacologic approaches for the perioperative treatment of ischemic cardiogenic shock. J Cardiothorac Vasc Anesth 19:97-108, 2005. Epinephrine Epinephrine, a naturally occurring catecholamine, is secreted from the adrenal medulla. The effects on ÃŽ ²Ã¢â‚¬â€œARs predominate at lower doses and on ÃŽ ±Ã¢â‚¬â€œARs at higher doses (> 0.1  µg/kg/min). It increases heart rate (HR), stroke volume (SV) and coronary blood flow (CBF). The rise in blood pressure (BP) results from increase in HR and cardiac output (CO). Systemic vascular resistance (SVR) decreases at low doses (ÃŽ ²2-AR effect) but increases at high doses (ÃŽ ± effect). It is metabolized in the liver by the enzymes catechol-O-methyl transferase (COMT) and monoamine oxidase (MAO), and the metabolites are excreted in urine. It has arrhythmogenic potential. In cardiac surgical patients it is used as an infusion at 0.01-0.4  µg/kg/min to wean patients with poor ventricular function off cardiopulmonary bypass (CPB). (Tables 1 and 2) Norepinephrine Norepinephrine is the postganglionic neurotransmitter in the sympathetic nervous system. It acts on ÃŽ ±1–AR, ÃŽ ±2–AR and ÃŽ ²1–AR, and has negligible action on ÃŽ ²2–AR. The ÃŽ ²1-AR action predominates at lower doses, thereby increasing inotropy, SV and CBF. It increases BP and SVR; but decreases HR. The CO remains unchanged. It has arrhythmogenic potential. The clinical dose range is 0.01 to 0.1  µg/kg/min. Like epinephrine, it is easily oxidized. It is metabolized by COMT and MAO and taken up by the sympathetic neurons. It decreases renal, hepatic, mesenteric and splanchnic blood flow. Dopamine Dopamine is a neurotransmitter in the central and peripheral nervous system. It is the immediate metabolic precursor of norepinephrine and epinephrine. It acts on ÃŽ ±Ã¢â‚¬â€œARs, ÃŽ ²Ã¢â‚¬â€œARs and dopaminergic receptors (DA1-DA5). At 0.5-3  µg/kg/min it increases renal and mesenteric blood flow (dopaminergic effects), between 3-8  µg/kg/min it increases HR and contractility (ÃŽ ²-AR effects) and, above 8  µg/kg/min it causes vasoconstriction (ÃŽ ±-AR effects). Intravenous dopamine does not cross the blood brain barrier. It is metabolized in the liver by COMT and MAO. Isoprenaline Isoprenaline has pure ÃŽ ²Ã¢â‚¬â€œAR agonist activity. It causes an increase in HR and contractility (ÃŽ ²1-AR effect) and decreases SVR (ÃŽ ²2-AR effect). CO increases due to combined ÃŽ ²1 and ÃŽ ²2-AR effect. It dilates pulmonary, skeletal, renal and mesenteric vascular beds. It is indicated in the treatment of pulmonary hypertension, bradycardia (especially after orthotopic heart transplantation), heart block and conduction abnormalities. It is used in the dose 0.01 to 0.1  µg/kg/min. it is metabolized in the liver by COMT. It is arrhythmogenic. Dobutamine Dobutamine is primarily a ÃŽ ²1-AR agonist and has positive inotropic effects. It causes modest increase in HR (ÃŽ ²2-AR effect) and decrease in SVR (ÃŽ ²2-AR effect). The clinical dose range varies from 2-15  µg/kg/min. It is particularly indicated in patients with myocardial pump failure. Its chemical structure lacks the hydroxyl group of catecholamines. It is metabolized in the liver, although not by COMT and MAO. It increases SV, CO and CBF. The arrhythmogenic potential is less than other catecholamines. Dopexamine Dopexamine is a synthetic analog of dopamine. It has potent ÃŽ ²2-AR and dopamine agonist properties and little ÃŽ ²1-AR and ÃŽ ±-AR activity. It causes vasodilation, increase in HR and inotropy. CO and renal blood flow are increased. It is used in the dose 1-10  µg/kg/min. It undergoes methylation and sulfation in the liver and is taken up into the tissues via extraneuronal catecholamine uptake mechanisms. Unlike other catecholamines, it lacks arrhythmogenic potential. Fenoldopam Fenoldopam mesylate is a dopamine DA1 receptor agonist that causes systemic and renal arteriolar vasodilation. It increases renal blood flow at doses of 0.05-0.1  µg/kg/min and reduces BP at 0.1-0.3  µg/kg/min. Phosphodiesterase inhibitors Phosphodiesterase inhibitors act by preventing the breakdown of cAMP, thereby prolonging its physiological response. They do not act via ÃŽ ²-AR stimulation. Their addition to a catecholamine has a synergistic effect in increasing inotropy. They also produce vasodilation and are termed ‘inodilators’. They improve myocardial diastolic relaxation (positive lusitropic effect) and augment coronary perfusion. The clinically used phosphodiesterase inhibitors include amrinone, milrinone and enoximone. Amrinone Amrinone is a bipyridine derivative. It provides positive inotropy and decreases SVR. The decrease in SVR is apparent immediately after administration, whereas positive inotropy is appreciable after 10-15 minutes. They are particularly useful in heart failure by increasing forward flow. It is administered as a bolus loading dose (0.5-1.5 mg/kg) followed by infusion (5-20  µg/kg/min). The potential side effects are thrombocytopenia (2-3%), gastrointestinal upset, myalgia, fever, hepatic dysfunction, ventricular arrhythmias and allergy. Milrinone Milrinone is a derivative of amrinone and is 20 times more potent. It does not cause fever or thrombocytopenia. It is administered as a bolus loading dose (50  µg/kg over 10 minutes) followed by infusion (0.375-0.75  µg/kg/min). Enoximone Enoximone is an imidazole derivative that has more pronounced vasodilatory effect than inotropic effect. It is administered as a bolus loading dose (0.5-1 mg/kg) followed by infusion (5-10  µg/kg/min). Levosimendan Levosimendan is a new inotropic agent belonging to the class of calcium-sensitizing agents, i.e., it sensitizes the myocardium to the actions of calcium. It has vasodilating and anti-ischemic properties mediated by opening of K+-ATP channels. The haemodynamic effects include increase in SV and CO and reduction in filling pressures, mean arterial pressure (MAP), mean pulmonary artery pressure (MPAP) and SVR. It also promotes lusitropy. It is useful in patients with compromised left ventricular function, difficulty in weaning from CPB and right ventricular failure. It is used in a loading dose of 12  µg/kg over 10 minutes followed by an infusion of 0.1  µg/kg/min. Calcium chloride Calcium ions play an important role in excitation-contraction coupling in the cardiac myofibrils. It has positive inotropic effect that is effective after CPB and in the short-term treatment of myocardial pump failure. The rise in BP occurs secondary to increased inotropy and vasoconstriction. However, it can attenuate the ÃŽ ²-AR effects of epinephrine in the postoperative cardiac surgical patients. It is administered in the dose of 2-4 mg/kg every 10 minutes. Calcium Gluconate the clinically available compound of calcium ,contains less than half of ionized calcium and has to be metabolized in the liver before action. VASODILATORS Vasodilators cause relaxation of arterial smooth muscle thereby reducing SVR and MAP. In addition, they also have venodilating property. They aid discontinuation of CPB by decreasing preload, right and left ventricular afterload, improving lusitropy and CBF. They are useful in the perioperative treatment of systemic and pulmonary hypertension, myocardial ischemia and ventricular dysfunction complicated by excessive pressure or volume overload. Sodium nitroprusside Sodium nitroprusside (SNP) acts by acting as a substrate for the formation of nitric oxide (NO) in the vascular endothelium. Binding of NO to its receptor induces a conformational change in the enzyme guanylate cyclase and production of cGMP from GTP. cGMP is the second messenger that eventually leads to vascular smooth muscle relaxation via numerous intermediate steps. SNP predominantly causes arterial and arteriolar vasodilation, but at high doses venodilation also occurs. Reflex tachycardia is apparent with its administration. SV and CO are increased only if the preload is maintained with intravenous fluids. SNP has a potential to cause ‘coronary steal’ phenomenon in patients with coronary artery disease as the epicardial coronary arteries also dilate diverting blood away from the stenosed endocardial coronary arteries. It decreases pulmonary vascular resistance (PVR) and MPAP. It abolishes hypoxic pulmonary vasoconstriction and may contribute to hypoxia. The infusion rate is 0.5  µg/kg/min, and titrated to effect. It is reconstituted in a dextrose-containing solution. SNP is sensitive to light, therefore the infusion syringe and tubing are wrapped with opaque material to prevent light induced structural breakdown of the drug. Cyanide toxicity may occur with the use of SNP above 1.5 mg/kg acute dose or 8  µg/kg/min chronic infusion. SNP is used during hypothermic CPB to promote uniform cooling by preventing cold induced vasoconstriction, to reduce the perfusion pressure, to reduce afterload by decreasing SVR and to increase pulmonary blood flow by decreasing PVR. Nitroglycerin Nitroglycerin (NTG) acts by the same mechanism as other nitrates. NTG is primarily a venodilator and reduces ventricular preload and myocardial oxygen consumption. NTG is of particular importance in patients with congestive heart failure as it unloads the left ventricle. It has modest effects on SVR and BP. It reduces PVR. The starting dose of intravenous nitroglycerin is 0.5  µg/kg/min which may be titrated to effect. Attention must be paid to the fluid status as CO may drastically reduce. At higher doses systemic vascular dilation occurs. NTG is helpful in coronary artery disease because it causes epicardial coronary artery dilation. It is metabolized in the liver. Methemoglobinemia occurs at high infusion rates. Intravenous nitroglycerin has a half-life of 1-3 minutes. Tolerance develops when administered for more than 8 hours. Nitric oxide Nitric oxide (NO) is the endothelium derived relaxing factor. Its mechanism of action has been described above. It has a very short half-life of 5 seconds. Inhaled NO promotes pulmonary vascular dilation. It can be used upto 80 parts per million (ppm) in patients with severe right ventricular failure and pulmonary arterial hypertension. As inhaled NO is rapidly taken up by the heme group of guanylate cyclase, it only acts locally in the pulmonary vascular bed causing pulmonary vasodilation. It has no systemic effects. Phenoxybenzamine Phenoxybenzamine is a non-competitive ÃŽ ±1 and ÃŽ ±2-AR blocker. It decreases PVR and SVR, thereby increasing CO. It is used to promote vasodilation during deep hypothermic circulatory arrest for uniform cooling and for the treatment of pulmonary hypertension. Phenoxybenzamine is a very potent and long acting vasodilator. It was traditionally used for afterload reduction, pulmonary vasodilatation, and in adrenal tumors such as pheochromocytoma. Phentolamine, a shorter acting agent is now more commonly used. VASOPRESSORS Vasopressors act on arteries and arterioles to increase SVR (ÃŽ ±-AR effect). They have some ÃŽ ² –AR effect also. Catecholamines such as norepinephrine, and epinephrine and dopamine at high concentrations are potent vasoconstrictors. In addition, sympathomimetics such as phenylephrine, methoxamine, ephedrine, metaraminol and mephentermine are also vasoconstrictors. They are metabolized by COMT and MAO. Phenylephrine Phenylephrine is a pure ÃŽ ±1-AR agonist and its primary action is to increase SVR. Reflex bradycardia may be seen. Vasoconstriction of renal, splanchnic and other vascular beds occurs. Coronary perfusion pressure is increased due to increase in diastolic pressure. The intravenous bolus dose is 50-100  µg and infusion rate is 0.5-1.0  µg/kg/min. Its effect is apparent in 1 minute and lasts upto 20 minutes. It is commonly used to increase SVR and therefore the perfusion pressure on CPB. Mephentermine Mephentermine has direct action on ÃŽ ±-AR and ÃŽ ²-AR, and indirect action by releasing norepinephrine at the nerve terminal. It increases CO and SVR. Its acts immediately on intravenous injection and it’s action lasts 30 minutes. It is used in 15-45 mg bolus doses and as 0.1% infusion titrated to effect. Vasopressin Vasopressin,a hormone of the anterior pituitary is a potent vasoconstrictor. It mediates vasoconstriction by inhibiting K+ ATP channels on vascular smooth muscles and blunting the rise in cGMP (due to NO and ANP) and cAMP (due to ÃŽ ²2-AR stimulation). It is one of the modalities of treating vasodilatory shock after CPB. It is used in the infusion dose of 0.01-0.1 U/min for this purpose. At higher doses it has the potential to cause renal and splanchnic vasoconstriction. It is also administered as a bolus dose of 40 U i.v. during cardiopulmonary resuscitation. Suggested reading Hoffman TM. Newerinotropesin pediatric heart failure. J Cardiovasc Pharmacol. 2011 Aug;58(2):121-5 Rognoni A, Lupi A, Lazzero M, Bongo AS, Rognoni G. Levosimendan: from basic science to clinical trials. Recent Pat Cardiovasc Drug Discov. 2011 Jan;6(1):9-15. Tavares M, Rezlan E, Vostroknoutova I, Khouadja H, Mebazaa A. New pharmacologic therapies for acute heart failure. Crit Care Med. 2008 Jan;36(1 Suppl):S112-20. Petersen JW, Felker GM. Inotropesin the management of acute heart failure. Crit Care Med. 2008 Jan;36(1 Suppl):S106-11 Ward RM, Lugo RA Cardiovascular drugs for the newborn.Clin Perinatol. 2005 Dec;32(4):979-97 Hug CC Jr. Making a choice ofinotropesandvasodilatorsin clinical situations.J Card Surg. 1990 Sep;5(3 Suppl):272-7 Stanford GG. Use of inotropicagentsin critical illness. Surg Clin North Am. 1991 Aug; 71(4):683-98.

Role Off Company Secretary

A Company Secretary is a person at very high position in a private sector company or public sector organization, normally at a managerial position. In some countries in a public sector the company secretary is reoffered as Corporate Secretary or Secretary. There is a requirement to appoint company secretary. It is already understood that a company is the creation of law, having rights, duties and obligations just as that of human being. The so-called legal entity may therefore sue and be sued: Saloman’s case. But because of the abstract nature of a company as a ‘person’ it becomes necessary that directors be put in place to see to the effective running of the corporation. However, the directors are not required to be lawyers nor know anything about the company law. In the same regard, the prompters of the company need not be lawyers or know anything about company law. But a company being an artificial person, created by operation of law, must subsist as a person on law – it must continue to obey the provisions of the law since it derives its existence as a person from it. Therefore it becomes necessary that the company be run effectively in a manner that conforms to the statutes and other regulations and best practices hence the need for a Company Secretary. The position of a company secretary is created by the law creation of law in section 293 -298 of the Companies and Allied Matters, Act, 2004 which provides for the appointment and functions of the Company Secretary, with special reference to public companies . The Company Secretary is responsible for the efficient functioning and administration of a company, particularly with regard to ensuring compliance with statutory and regulatory requirements and for ensuring that decisions of the Board of Directors are implemented. [1] Even though the name suggests the job of a clerk or secretary it is nothing related to it. The company secretary ensures that an organization complies with relevant legislation and regulation, and keeps board members informed of their legal responsibilities. Company secretaries are the company’s named representative on legal documents, and it is their responsibility to ensure that the company and its directors operate within the law. It is also their responsibility to register and communicate with shareholders, to ensure that dividends are paid and to maintain company records, such as lists of directors and shareholders, and annual accounts. In many countries, private companies have traditionally been required by law to appoint one person as a ompany secretary, and this person will also usually be a senior board member. A company secretary is one of the senior board members according to the law in India. Most people forming a company undervalue the importance of a company secretary. The company secretary is the named representative on legal documents and it is their responsibility to advice the directors of their corporate compliance obligations. In moat established companies the company secretary serves as a focal point between the board of directors, senior management and the company’s shareholder. Since 6th April 2008 there is no longer a legal requirement to have a company secretary, although many limited companies appoint one to cover a range of jobs roles. A job of a company secretary is to organize and prepare agendas. A company secretary takes minutes at the board meeting and annual general meetings. Filing with the companies house, maintaining company records and statutory books are some of the important deals of company secretary. A company secretary deals with stock transfer and dividends he ensures the security of the company’s legal documents. He also ensures compliance with all the legal and the statutory requirements. He builds up a contact with external and regulatory bodies Roles and responsibilities The Company in all sectors have high level responsibilities including governance structures and mechanisms, corporate conduct within an organization’s regulatory environment, board, shareholder and trustee meetings, compliance with legal, regulatory and listing requirements, the training and induction of non-executives and trustees, contact with regulatory and external bodies, reports and circulars to shareholders/trustees, management of employee benefits such as pensions and employee share, insurance administration and organization, the negotiation of contracts, risk management, property administration and organization and the interpretation of financial accounts. Company secretaries are the primary source of advice on the conduct of business and this can span everything from legal advice on conflicts of interest, through accounting advice on financial reports, to the development of strategy and corporate planning. Among public companies in North America, providing advice on corporate governance issues is an increasingly important role for corporate secretaries. Many shareholders, particularly institutional investors, view sound corporate governance as essential to board and company performance. They are quite vocal in encouraging boards to perform frequent corporate governance reviews and to issue written statements of corporate governance principles. The corporate secretary is usually the executive to assist directors in these efforts, providing information on the practices of other companies, and helping the board to tailor corporate governance principles and practices to fit the board's needs and expectations of investors. In some companies, the role of the corporate secretary as corporate governance adviser has been formalized, with a title such as Chief Governance Officer added to their existing title. In view of the important roles the company secretary plays in business, PLC’s and large companies require the company secretary to be suitably trained, experienced and professionally qualified for these responsibilities. In the UK, the company secretary may be qualified by virtue of examination and membership of the institute of chartered company secretary and administration (ICSA), which is the main qualification specifically for company secretaries. ICSA is the body dedicated to the advancement and recognition of professional administration based on a combination of degree-level studies, carefully vetted experience and sponsorship by two people of professional status. Only a person thus qualified is entitled to be designated a ‘Chartered Secretary' or ‘Chartered Company Secretary'. The Faculty of Secretaries and Administrators founded in 1930 is the second body of corporate secretaries in the United Kingdom and now has a strong emphasis on equality work and governance and its members are designated ‘corporate secretaries' or ‘certified public secretaries'. It is expected that Company Secretaries of Publicly Quoted Companies will be professionally qualified through ICSA, one of the Chartered Professional Bodies in the Accountancy Profession or have appropriate training and experience through another body. In India, the Institute of Company Secretaries of India (ICSI) regulates the profession of Company secretaries. ICSI is a statutory professional body which has more than 29,010 associate members. Chartered secretaries are employed as chairs, chief executives and non-executive directors, as well as executives and company secretaries. Some chartered secretaries are also known in their own companies as corporate secretarial executives/managers or corporate secretarial directors. Chartered Secretaries are the sixth highest paid employees in the UK according to the Office for National Statistics Annual Survey of Hours and Earnings (March 2010). Many corporate secretaries of North American public companies are lawyers and some serve as their corporation's general counsel. While this can be helpful in the execution of their duties it can also create ambiguity as to what is legal advice, protected by privilege, and what is business advice. In India every company having a paid up share capital of Rs. 50 million (5 crores) or more is required to appoint a qualified person as Company Secretary. A company having not less than Rs. one million (10 lacs) paid up capital and not required to appoint a full-time company Secretary should file a compliance certificate signed by a practising Company Secretary with the Registrar of Companies. Section 383A of the Companies Act, 1956 provides for the mandatory appointment of a whole time secretary where the paid up capital of the Company exceeds Rs. 50 million (5 crores). If the capital is less than Rs. 50 million (5 crores), the company is required to obtain a secretarial compliance certificate and attach the same to the Directors' Report and file it with the Registrar of Companies. Statutory declarations of compliance under various other provisions of the Companies Act, 1956 are also to be certified by practicing company secretaries. Under the MCA 21 e filing regime several forms (including some, exclusively) are required to be pre-certified by practicing company secretaries. The MCA 21 regime has ushered in a dramatic change in the role and profile of the profession, particularly, the practicing side. The annual returns of companies listed on recognized stock exchanges are to be signed by a practising company secretary. Further, the Securities and Exchange Board of India (SEBI) also recognizes the Company Secretary as the Compliance Officer and the practicing company secretary to issue various certificates under its Regulations. Further, the practicing Company Secretaries are also authorized to certify compliance of conditions of corporate governance in case of listed companies. The Reserve Bank of India also authorizes company secretaries to issue various certificates. The Institute of Company Secretaries of India is the premier professional body to develop and regulate the profession of Company Secretaries in India. It was set up by an Act of Parliament in 1980. When the Companies Bill, 2011 will be passed by the parliament and becomes an Act, the National Company Law Tribunal (NCLT) will be given powers of a court and all matters relating to Company Law would be heard before it instead of High Court. A Company Secretary would be eligible to appear before NCLT. This will open more opportunities for a Company Secretary. What Does a Corporate Secretary Do? So just what does a Corporate Secretary* do, anyway? A good question, but difficult to answer! While the basic duties of the Corporate Secretary can be outlined easily, the position's overall responsibilities–and the fit of the role within senior management–vary and are more difficult to explain. A â€Å"Corporate Secretary† is required by state corporation laws for every corporation; he or she is, at the most basic level, the individual who keeps the official records and minutes of the corporation. Corporate by-laws set forth the powers and duties of the Corporate Secretary and other corporate officers. One may think that the Corporate Secretary is merely a combination of scrivener and custodian, but this is not the case in practice. The Corporate Secretary in today's world is a senior corporate officer with wide-ranging responsibilities, who serves as a focal point for communication with and between the board of directors, senior management and the company's shareholders, and who has a key role in the administration of the Board and critical corporate matters. The Corporate Secretary is often a confidante and counselor to the Chief Executive Officer, members of the Board, and other members of senior management, especially on corporate governance matters. A key responsibility for the Corporate Secretary is to ensure that Board members have the proper advice and resources for discharging their fiduciary duties to shareholders under state law. A Corporate Secretary also is responsible for ensuring that the records of the Board's actions reflect the proper exercise of those fiduciary duties. Some Corporate Secretaries who are lawyers handle this function themselves; others partner with the General Counsel and/or outside counsel. The function ranges from making sure new directors have training in the applicable state law duties and the business of the company, to ensuring that management follows the proper steps for major corporate actions such as share issuances, the declaration of dividends, and mergers, acquisitions, or dispositions of corporate assets. A Corporate Secretary also provides advice on corporate governance ssues, particularly related to the re-election of directors and other shareholder action taken at Annual Meetings. Many shareholders, particularly institutional investors, view sound corporate governance as essential to board and company performance. The Corporate Secretary is usually responsible for a comp any’s Corporate Governance Principles or Guidelines. In some companies, the role of the Secretary as corporate governance adviser has been formalized, with a title such as Chief Governance Officer or Corporate Governance Officer added to their existing title. Most Corporate Secretaries are responsible for the following : (More details are available by clicking on some of these topics. ) 1. Board and Committee Meetings