Random documents and papers

Why George R.R. Martin Reigns Supreme Over J.R.R. Tolkien

2023-04-14T09:47:00.005-07:00

When it comes to the world of epic fantasy literature, two names stand out: George R.R. Martin and J.R.R. Tolkien. Both authors have captivated readers with their immersive worlds and richly crafted characters, but when it comes to comparing the two, George R.R. Martin undeniably takes the throne as the superior storyteller.

One of the reasons why Martin surpasses Tolkien is his realistic and complex portrayal of human nature. Martin's characters are flawed, multi-dimensional, and morally ambiguous, making them relatable and compelling. He doesn't shy away from depicting the darker aspects of human behavior, such as political intrigue, betrayal, and the consequences of power struggles. In contrast, Tolkien's characters tend to be more archetypal, with clear-cut divisions between good and evil, and less depth in their motivations and actions.

Furthermore, Martin's world-building is unparalleled in its intricacy and detail. The fictional realm of Westeros in his "A Song of Ice and Fire" series is meticulously crafted, with its complex history, geography, and cultures. Martin's attention to detail in creating a fully realized world, complete with its own customs, religions, and politics, adds a layer of authenticity and richness to his storytelling that Tolkien's Middle-earth, while impressive, does not quite match.

Another area where Martin shines is his willingness to subvert traditional fantasy tropes. He challenges the notion of the invincible hero, as characters meet untimely and unexpected demises, defying readers' expectations. This unpredictability and sense of jeopardy add a sense of realism to his stories, keeping readers on the edge of their seats. Tolkien's narratives, on the other hand, often follow a more traditional hero's journey with clear-cut lines of good versus evil, and fewer surprises.

Additionally, Martin's exploration of social issues, such as gender roles, sexuality, and power dynamics, adds a contemporary relevance to his works. He portrays female characters as strong, capable, and complex, defying gender stereotypes, while also delving into the nuances of power dynamics and their impact on individuals and societies. Tolkien's works, on the other hand, are criticized for their lack of diversity and representation, with male characters dominating the narrative.

Lastly, Martin's writing style is known for its rich prose, sharp dialogue, and vivid descriptions. His ability to create memorable and quotable lines has earned him a legion of devoted fans. Tolkien's prose, although poetic and evocative, can be considered more dense and less accessible to modern readers.

In conclusion, while both George R.R. Martin and J.R.R. Tolkien have made indelible marks in the fantasy genre, Martin's realistic and complex characters, intricate world-building, willingness to subvert tropes, exploration of social issues, and engaging writing style all contribute to his superiority as a storyteller. His works have redefined the fantasy genre and continue to captivate readers with their gritty, morally ambiguous, and unforgettable tales.

What is proof?

2023-03-30T13:46:00.003-07:00

This is proof

The link between cryptocurrency and obesity

2023-02-14T16:30:00.003-08:00

There is no direct association between cryptocurrency and obesity, but a recent study has shown that people who invest in cryptocurrencies tend to have a higher Body Mass Index (BMI) compared to those who do not invest in this new form of digital currency.

One reason for this correlation could be the sedentary lifestyle that often accompanies cryptocurrency investing. Crypto investors tend to spend a lot of time sitting in front of their computer screens, researching different digital assets, and monitoring market trends. This can lead to a lack of physical activity and contribute to weight gain.

Moreover, crypto investing often leads to stress and anxiety due to the volatile nature of the market. This stress can lead to overeating and indulging in unhealthy food choices, which can further contribute to obesity.

Another factor that could be contributing to this association is the availability of unhealthy food options for crypto investors. Many fast food chains and delivery services accept cryptocurrency payments, which makes it easier for investors to indulge in unhealthy food choices while they are busy monitoring their digital assets.

It is important to note that this study does not suggest that cryptocurrency itself causes obesity. Instead, it is the lifestyle and behaviors associated with crypto investing that could contribute to an increased risk of weight gain.

In conclusion, while there is no direct association between cryptocurrency and obesity, there is a correlation between the two. It is important for crypto investors to prioritize their health and make time for physical activity and healthy eating habits. Incorporating these habits into their lifestyle can help reduce the risk of obesity and improve overall well-being.

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"The office" Television show is actually about death

2023-02-14T16:24:00.004-08:00

At first glance, the hit television show "The Office" may seem like a simple workplace comedy. But upon closer examination, it becomes clear that the show is actually about much more than that - at its core, it is about death.

Throughout the series, death is a recurring theme. Whether it is Michael Scott's fear of dying alone or the passing of several beloved characters, death is a constant presence. However, the show does not present death in a dark or morbid way - instead, it uses it as a way to explore the complex emotions that come with being alive.

One of the most poignant examples of this is the death of Ed Truck, Dunder Mifflin's former regional manager. Although he is only mentioned briefly in a few episodes, his death has a profound impact on the characters. Michael, in particular, becomes obsessed with the idea that he too will die alone and be forgotten, leading to some of the show's most memorable and touching moments.

Similarly, the death of Jim's father is a turning point for his character. It is only after his father's passing that Jim decides to take a chance and pursue a relationship with Pam, leading to one of the most iconic love stories in television history.

Even smaller moments, such as the death of Creed's "mysterious" friend or the passing of Angela's cat, serve to underscore the idea that death is an inevitable part of life.

However, what sets "The Office" apart from other shows that deal with death is its ability to find humor and joy in even the darkest moments. For example, the funeral of Ed Truck is an incredibly touching scene, but it is also filled with comedic moments - such as when Dwight shows up in a "Schrute Farms" shirt and tries to give a eulogy.

Ultimately, "The Office" is about more than just the mundane details of office life - it is a show about what it means to be human, and the inevitability of death. While this may sound like a depressing subject matter, the show manages to find hope and humor in even the darkest moments, making it a truly unique and unforgettable viewing experience.

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My favourite poem from English Literature GCSE

2023-02-14T16:09:00.003-08:00

The poem "Vultures" by Chinua Achebe is widely regarded as a masterpiece of modern African poetry, and is included in the AQA GCSE English Literature anthology. There are several reasons why this poem is considered so good, and some of the key reasons are discussed below.

First and foremost, "Vultures" is a highly evocative and powerful poem that uses vivid imagery and stark contrasts to convey its themes. The opening lines of the poem describe a pair of vultures perched on a tree branch, observing a concentration camp during the Holocaust. The description of the vultures, with their "bashed-in head[s] and a pebble for an eye," is both disturbing and poignant, and sets the tone for the rest of the poem. By juxtaposing the natural world with the horrors of the concentration camp, Achebe creates a powerful sense of tension that draws the reader in and compels them to keep reading.

Another reason why "Vultures" is so effective is that it deals with universal themes that are relevant to people of all cultures and backgrounds. The poem is not just about the Holocaust or the vultures themselves, but about the nature of evil and the complexity of human behavior. Achebe's portrayal of the vultures, with their dual nature of both predator and caretaker, serves as a metaphor for the paradoxical and sometimes contradictory nature of human behavior. The poem invites the reader to reflect on their own capacity for both cruelty and compassion, and to consider the ways in which these two impulses can coexist within us all.

Finally, "Vultures" is a beautifully crafted poem that showcases Achebe's skill as a writer. The language and imagery are rich and precise, and the structure of the poem - with its shifts in tone and perspective - is carefully designed to create a powerful and lasting impression. By the end of the poem, the reader is left with a haunting sense of the fragility of life and the ways in which good and evil are intertwined.

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What is the most influential passage in the Bible?

2023-02-14T16:02:00.002-08:00

The Bible is one of the most widely-read and influential books in human history. It is the primary religious text for Christians and is considered a source of guidance, wisdom, and spiritual insight. Throughout the Bible, there are many passages that have had a profound impact on the world and have shaped the course of human history. One of the most influential Bible passages is the Sermon on the Mount, found in the Gospel of Matthew.

The Sermon on the Mount is a collection of teachings and sayings of Jesus, delivered on a mountainside to a large crowd of followers. The sermon is recorded in Matthew 5-7 and covers a wide range of topics, including morality, ethics, prayer, and faith. It includes some of the most famous teachings of Jesus, such as the Beatitudes, the Lord's Prayer, and the Golden Rule.

The Beatitudes, found in Matthew 5:3-12, are a series of blessings that describe the characteristics and virtues of a blessed life. These blessings have been interpreted in different ways by various Christian traditions, but they are generally understood as a call to live a life of humility, compassion, and righteousness. The Beatitudes have been a source of comfort and inspiration for generations of Christians, and have been referenced in countless sermons, songs, and works of art.

The Lord's Prayer, found in Matthew 6:9-13, is a model prayer that Jesus taught to his disciples. It is a simple yet powerful prayer that expresses a deep trust in God and a desire for his will to be done on earth as it is in heaven. The Lord's Prayer has been recited by Christians in many different contexts, from personal devotions to public worship services, and has been translated into countless languages.

The Golden Rule, found in Matthew 7:12, is a simple but profound principle that has been embraced by many different religious and philosophical traditions. It states, "So in everything, do to others what you would have them do to you, for this sums up the Law and the Prophets." The Golden Rule has been a guiding principle for Christians throughout history, and has been used as a basis for ethical and moral teachings in many different contexts.

In conclusion, the Sermon on the Mount, and particularly the Beatitudes, the Lord's Prayer, and the Golden Rule, are among the most influential passages in the Bible. They have inspired countless people to live lives of faith, compassion, and righteousness, and have shaped the course of human history in countless ways. Whether you are a Christian or not, these teachings are a valuable source of wisdom and insight that can help guide you on your own spiritual journey.

Best games to play in Coronavirus quarantine lockdown.

2020-04-30T15:42:00.001-07:00

With most countries in lockdown, and social distancing it place, it can be difficult to have fun with your friends.

This is a post to share my favourite games to play online/over skype/zoom.

1) Codenames online

https://www.horsepaste.com/

This website is a similar game to the board game codenames. However, can be played online and is very easy to play over zoom. I've done this and it works a treat. I would recommend it to anyone who enjoys word games.

The game is essentially a word description game in which there are 2 teams. Each team has a 'spymaster' who has to describe as many of 'their' words from a 5x5 grid. They are only allowed to describe 'their words' using a one word hint and a number. The aim is to try and describe as many words as possible with a single hint.

2) Ticket to ride

https://www.daysofwonder.com/online/en/t2r/

This is a great game which I have played in person as a board game with my friends pre lockdown. The game has a good app made by the company days of wonder. It is a cross platform game so you can play with people who have steam, ios or windows.

What makes the game really good is that each player is involved for quite a long time and thinks that they can win all the way through the game (unlike many other board games where if one person starts winning everyone else can get a bit disinterested).

Passive income

2019-07-22T16:03:00.001-07:00

The Futility of Chasing Passive Income

The concept of passive income has gained immense popularity in recent years, often portrayed as a ticket to financial freedom and a life of leisure. Many individuals are enticed by the idea of earning money while they sleep, and they embark on journeys to build passive income streams through various means such as real estate investments, dividend stocks, online businesses, and more. While passive income can indeed provide financial benefits, it is crucial to recognize the inherent futility in chasing it as a sole financial strategy. This essay will explore why chasing passive income can be a futile pursuit, highlighting the misconceptions, challenges, and limitations associated with this quest.

Misconceptions Surrounding Passive Income

One of the primary reasons chasing passive income can be futile is the common misconceptions that surround it. Passive income is often portrayed as effortless money, but this portrayal fails to account for the hard work, time, and capital required to establish and maintain passive income streams. Many aspiring passive income earners underestimate the initial investments, learning curves, and ongoing efforts involved in creating and sustaining these income sources.

Lack of Guaranteed Success

While the promise of passive income can be alluring, there is no guarantee of success in these ventures. Investments in real estate, stocks, or online businesses are subject to market fluctuations, economic downturns, and unforeseen challenges. Relying solely on passive income streams leaves individuals vulnerable to unexpected financial setbacks, as these sources of income may not always perform as expected.

Capital and Risk Considerations

Chasing passive income often requires a significant initial capital investment. Whether it's purchasing rental properties, investing in dividend stocks, or starting an online business, substantial upfront capital is necessary to establish these income streams. Additionally, many passive income opportunities come with inherent risks, which can lead to financial losses. In some cases, individuals may have to assume substantial debt to enter the passive income game, putting their financial stability at risk.

The Illusion of Passive Effort

The term "passive" implies minimal effort or involvement, but in reality, passive income sources often demand ongoing attention and maintenance. Rental properties require regular maintenance, tenant management, and market research. Dividend stocks require monitoring and financial analysis. Online businesses need constant updates, marketing efforts, and customer support. The illusion of passive effort can lead to frustration when individuals realize the ongoing commitment required.

Limitations of Scaling

Scaling passive income streams can be challenging. While it's possible to increase income from investments or businesses, there are limits to how much one can scale without exponentially increasing effort, capital, or risk. This limitation can hinder the pursuit of significant financial freedom through passive income alone.

The Importance of Diversification

Relying solely on passive income sources can lead to financial vulnerability. Diversification is a fundamental principle of sound financial planning, as it helps mitigate risks associated with a single income stream. Chasing passive income to the exclusion of other financial strategies can result in a lack of diversification, leaving individuals exposed to the whims of a particular market or business niche.

Conclusion

Chasing passive income can be a futile endeavor if not approached with a clear understanding of its complexities, risks, and limitations. While passive income can provide supplemental financial benefits, it should not be viewed as a guaranteed path to financial freedom. The misconceptions surrounding passive income, the lack of guaranteed success, capital and risk considerations, the illusion of passive effort, limitations of scaling, and the importance of diversification all contribute to the argument that relying solely on passive income is an unreliable and potentially precarious financial strategy. Instead, individuals should approach passive income as one component of a diversified financial plan, complemented by active income, prudent savings, and careful investment strategies to build a robust and resilient financial future.

How to insert a catheter

2017-12-16T18:18:00.002-08:00

Hand hygiene

Introduce

Gain consent

I've been asked to insert a catheter to allow us to monitor your urine output

This will involve putting a thin flexible tube into thebladder

Before I put the tube in I will insert some local anaesthetic which should make the procedure as comfortable as possible.

One of the staff will be present as a chaperone

Chaperone

Do you have any allergies at all?

Urinary retention?

Check in the notes about bladder scan?

Assemble equipment:

APRON

Woundcare pack

Saline

Catheter

Catheter bag

Instilagel

Sterile gloves (x2 There is one in the pack)

Incopad

Check patient ID using bracelet

Clean trolley

Open pack

Put in saline and instilagel in field

Arrange patient

Perform hand hygiene and put on gloves

Arrange the sterile towel

Retract foreskin

Clean head of the penis with saline

Wiping away from the urethral meatus

How many

Use intilagel and wait for up to 3 minutes

Inject a bit in the tray

Remove gloves

Put in catheter and bag on field

Perform hand hygeine and replace gloves

Attach catheter to bag

Coil catheter and put bag between patients legs

Insert catheter

Ask to cough if resistance at prostate

Put in 10cm after the flow of urine

Inflate bladder

Gently pull on catheter so it sits in neck of bladder

Thank the patient

Clean up

Document procedure in notes

Perform hand hygiene

How to break bad news for an OSCE

2015-12-18T00:05:00.001-08:00

Breaking bad news seems like a daunting prospect however during an OSCE it is quite predictable.

1. Confirm patient identity

2. Then introduce yourself: My name is .... I am one of the doctors in the team that's looking after you.

3. Ask how they are feeling/ are they in pain.

4. Bring up the topic - I've been told to speak to you today about.... (e.g your leg, your blood results)

5. Find out where the patient is currently at/ what they know:
Could you tell me what's been going on so far?
How do you feel that it's been progressing?
Has anything been worrying you?
Do you have any idea of the possible treatments?

6. Slowly break the news:
The team have had a discussion about ...... The situation is not as we would have hoped
PAUSE
Unfortunately .... (the current treatment is anadequate... (or words to this effect but more specific))
PAUSE
I'm sorry to say this, but this would mean....
SUPER PAUSE

(let the patient speak as much as possible)

7. Facilitate with empathetic statements
I can understand that this is a really big shock for you
This must be very difficult news to process
Can you tell me what's going through your head at the moment

8. You won't be going through this on your own and the team will be with you for every part of it.
I
9. One of my colleagues will come to speak to you later about planning.

Routine for a Knee exam for an OSCE

2015-11-23T12:55:00.004-08:00

How to do a knee exam for an OSCE:

Wash hands + Introduce and gain consent
Check for pain status.
LOOK

Observe gait

Comment on ratio between stance phase and swing phase
e.g Antalgic gait - stance phase reduced on painful side.
Stepping height

Observe from front while standing

Scars
Swellings/colour
Assymmetry
Valgus/Varus

Observe from side while standing

Fixed flexion deformity

Observe from back while standing

Popliteal swelling
Scars/assymetry

Observe from side while standing

Fixed flexion deformity

Get patient to lie on bed

Check once more for cheeky arthroscopy scars

FEEL

With the leg extedned

Feel for temperature
Feel for effusion

Milk and patella tap or sweep test

Offer to measure the quadriceps 20cm above tibial tuberosity

With the leg flexed

Feel around the patella
Feel the tibial tuberosity (Osgood Schlatter's disease)
Feel head of the fibula
Feel the joint line
Feel the collateral ligaments
Feel the popliteal fossa

MOVE

Passive

Knee flexion (feel for crep)

Knee extension
Hyperextension, pick up the heel slightly

Active

Bend the knee as much as possible

Heel to bum distance - compare

Special test

Anterior drawer and posterior drawer test - when leg is flexed at 90deg

Sit on the patients leg and move the tibia

(alternatively do lachman's test which is the same but bent around 30 degrees)

Assess MCL and LCL

Do McMurray's test for menisci

To test medial meniscus- Push on the lateral side of knee (valgus) externally rotate and extend

To test lateral meniscus - Push on medial side of knee (valgus) and internally rotate and extend

Get patient to Sit on edge of the bed

Check for J-shaped tracking.

What questions should you ask about in a systems review?

2015-10-27T16:18:00.004-07:00

Remember you should always ask about the General topics and also the RELEVANT system. There may be more than 1 relevant system e.g Cardio and respiratory normally go together.

General

Fever

Fatigue

Sleep

Weight/appetite

Skin bruising/rashes

Head

Headache

Loss of consciousness

Dizziness

Vision

Hearing

Weakness

Numbness

Loss of memory

Anxiety or depression

CVS

Chest pain

Claudication

quantify

Breathlessness

Quantify

Orthopnoea

PND

Ankle swelling

Palpitations

Chest pain

Cough

Sputum

Blood?

Breathlessness

Wheeze

GIS

Appetite

Dysphagia

Nausea and Vomiting

Indigestion

Jaundice

Abdominal Pain

Bowel movements

Blood?

Pale?

Genito urinary

Dysuria (pain)

Urine frequency

Haematuria

Incontinence

Prostate

Starting, flow, dribbling

Menstruation

Onset, Timing + Regularity, Length

Women - vaginal discharge, pain on intercourse

Muscular

Pain/swelling/stiffness

Wash and dress

Climb stairs.

How to do an abdominal exam for an OSCE

2015-10-27T16:16:00.003-07:00

Key point- Abdominal exam is tight for time so really try and race through the early peripheral signs in hands and face.

The routine for Abdo

Wash hands

Introduce

Consent + Explanation

Explanation of talking to examiner

Pain

Observe from end of bed

Look around

Drains

Lines

Food/drink

Look at patient

Comfort

Well perfused

Alert

Orientated

Hands

Leuconychia

Koilonychia

Clubbing

Tendon xanthomata

(turn over)

Erythema

Dupuytren's

(pigmentation of creases?)

Arms

Asterexis

Pulse

Fistulae

Blood pressure

Axilla hair

Acanthosis nigricans

Face

Eyes

Pallor

ictarus

KF rings

Corneal arcus or xanthalesma

Mouth

Angular stomatitis

Glossitis

Ulcers

Pigmentation

Telangiectasia

Neck

JVP

Lymph nodes

When you have patient up look for scars.

FLATTEN BED!!!

Chest

Gynaecomastia

Hair distribution

Spider naevi

Acanthosis nigricans

Abdomen

Inspect

Scars or stoma

Visible masses, pulsations or peristalsis

Visible veins

Striae

Palpate

ASK ABOUT PAIN AGAIN

For pain, look at patient

For massess

LIVER

Spleen

Kidney

Aorta

Pecuss

Each area

Borders of liver

Spleen

Bladder

Ascultate

Bowel sounds

Bruits

Aortic, renal

Legs

Pedal oedema

To complete

Hernial orifices, external genitalia, DRE

Temp, Urine dip

How to do a hand exam for an OSCE

2015-10-27T16:12:00.001-07:00

The routine - neurological exam is brief and only if indicated.

Wash hands introduce and gain consent

Ask for pain
Expose arms to above elbows.

Examine extensor surfaces

Looking for nodules, psoriatic plaques, scars, tophi.

Inspection of Dorsum of hand (proximal to distal)

Skin

Rash

Atrophy
Nodules
Tophi
White fingers
Sclerodactyly

Purpura (use of steroids)

Nails

Pitting
Onycholysis - nail coming off (may suggest psoriatic)
Splinter haemorrhages or clubbing.

Suggestive of vascular.

Soft tissue

Wasting in dorsal interossei or diffuse atrophy

Swelling in gutters of MCP

Bones

Wrist - sublaxation of carpus/distal radioulnar joint

MCP - swelling and/or sublaxation/ulnar deviation
IPJ - swelling, Swan neck, Boutoniere or Z deformity in thumb. Heberden's nodes and/or Bouchard's nodes.
Dactylitis and PIPJ and/or DIPJ swelling in psoriatic arthritis.

Inspect Palmar surface of hand.

Skin - palmar erythema, pallor, calcinosis or vasculitis

Muscles - wasting of intrinsics, thenar eminence or hypothenar?

Palpation

Feel temperature - above and below and then on joint

Feel for swelling on the joint

Boggy synovial swelling

Effusion (fluctuant)

Bony swelling (hard) (e.g heberden's node)

Feel for tenderness

Special tests

Depress distal ulna

MCP squeeze
Bimanual palpation of IPJ

MOVE

With forearms supinated make a fist

Flexion of MCP and IP.

Pronate forearms

Extend little finger alone

To check extensor tendon - little finger is EWS.

Extend all fingers
Place palms together

Tells you for flexion deformities in IP joints
Then bend wrists (so shows wrist extension)

Place dorsums together and bend hands

Shows wrist flexion.

Special tests

Squeeze 2 fingers (power grip)

Pincer grip - test strength
Hold paper between fingers
Hook grip - test strength

You could ask doing some buttons or writing.

Neurology

Sensory exam

Outside of index finger

Outside of little finger
1st web space on dorsum

Distal middle finger

Glove distribution test

Motor

Abduction or adduction
Abduction of thumb
Extension of wrist
Hook grip (c8 already tested)

Consider Tinel's and Phalen's test/

How to do a GALS exam for an osce

2015-10-27T16:10:00.004-07:00

A key point - remember that GALS is a screening exam.

THE ROUTINE

Would it be okay if I did an examination of the joints in your body

This will involve observing your walking, examining at your neck, back, arms and your legs

Ask if patient is in pain before starting.

Questions

Pain or stiffness in any muscles or joints?

Any trouble washing or dressing?

Any trouble climbing up & Down the stairs

Examination

Gait

Walk across the room and turn around and walk back

Comment on stride length, symmetry, smoothness and ease of turn

Spine

Look from the side

for kyphosis/lordosis

Look from the back

for scoliosis

Any assymmetry

Shoulders and iliac crest

Obvious valgus/varus in knees

Look at ankles for hindfoot alignment

Look at lumbar spinal extension as they bend over

Test cervical spine by getting them to put their ear on their own shoulder

Press the middle of supraspinatous to check for Fibromyalgia

Arms

Hold hands out

Look for any swelling around the joints or muscle wasting in interossei

Supinate hands

Checking supination

Also look for small muscle wasting in the hands

Make a fist

Do a pincer grip

Squeeze the MCP

Indicates synovitis

Straighten arm look at elbow angles

Fixed flexion deformity

Hold hands behind head to test external rotation and abduction

Legs

Lie down on couch

Examine

Wasting or swelling

Check temeprature

Fluid shift test

Bend the knee feeling for creptiations

Check for internal rotation of hip (often first movement to go)

Bend the knee fully when doing this

Look at feet for callouses

Squeeze MTP

Indicates synovitis

How to do a respiratory exam for an OSCE

2015-10-27T16:09:00.000-07:00

When doing an exam for the osce, it is important to have a routine.
Here is one. In this routine the following will always be commented on.

The routine for resp

Wash hands

Introduce

Consent + Explanation

Explanation of talking to examiner (explaining this to the patient)

Pain

Observe from end of bed

Look around

Look at patient

Comfort

Well perfused

Alert

Orientated

Hands

Peripheral cyanosis

Tar staining

Clubbing

Palmar creases

Hypothenar wasting

Tender wrists

Arms

Pulse

Resp rate

CO2 retention flap

Face

Conjuctival palor

Horner's syndrome

Central cyanosis

Neck

JVP

Trachea

Deviation

Cricosternal distance

Tracheal tug

(Come back and get your lymph nodes)

Chest

Inspect

Type of breathing

Paradoxical chest movements

Apex beat

Chest expansion

TVF

Percuss

Ascultate

Vocal resonance

Back

Check lymph nodes

Check for chest expansion

TVF

Percuss

Vocal resonance

Ascultate

Sacral oedema

Legs

Ankle oedema

To complete

O2 sats, temp, obs, sputum pot, PEFR

What type of questions do they ask you in an Oxbridge medicine interview?

2015-09-29T10:45:00.001-07:00

"What questions did they ask you in your Cambridge interview?" was one of the most common questions that I got asked after my interview.

The interview day itself was split into 3 separate interviews.

2 of these interviews were completely science based. The last interview was a 'personal' interview, although I was asked 'non-personal' questions in this.

Generally the questions that they ask you are abstract questions which make you think.
What the interviewer is after is not how factually correct your answer was, but how you put your answer together and how you thought it through.

A common theme that I found in all my interviews was that they will try and push you till you can no longer answer. At the time I felt quite deflated that I could no longer answer the question, but this is probably a good thing.

The type of questions they may ask you:

How would you calculate how much blood you have inside your body?

Why do we have two eyes? Why not 3?

Drawing graphs - they often draw a graph on a paper and ask you to do something with it. e.g what does the area under the curve represent. what does the gradient represent.

How do radiographs (x-rays) work? (they won't ask you to interpret any films)

If I connected one of your arteries to a tube and held it vertically, how tall would it have to be, before blood stopped spilling out?

What changes occur in your body when you start exercising?

The 'personal' interview has some science questions but they will also ask you questions about what you enjoy doing in your free time.

I was NOT asked about why I wanted to do medicine in the whole interview.

Clinical communication skills - phrases you could use in the Cambridge-Calgary model for information gathering

2015-04-15T22:44:00.000-07:00

Introduce yourself

Set agenda and obtain consent

Check comfortable

Presenting complaint

Opening question

So could I start by asking you, what problems brought you into hospital today?

Summarise and screen

So you've told me x and y. Have you noticed anything else?

Screen once more or until she says nothing else

Have you noticed any other problems?

Are there any other problems that you would like to tell me about

HPC

So can you take me back to the beginning from when the problems first started?

Obtain chronology

Empathy statement - this sounds like it must have been difficult for you

Take each item in turn

Can you tell me more about that?

Systems review

I'd like to ask you a few more specific questions if that's okay

ICE

So, before you came in did you have any ideas of what might be going on?

Is there anything that’s worrying you at all?

What where you hoping to happen by the end of the consultation?

PMH

I'd like to ask about your PMH

Have you ever had any surgeries at all?

Have you ever had to come to hospital before?

Is there anything that you see your GP regularly for?

Medication

Smoking

Alcohol

Social history

Do you live at home on your own?

And at home are you quite independent/ do you manage?

Do you work?

How has all this been affecting your work?

Are there any conditions that run in your family?

Do you have any brothers or sisters that suffer from anything?

Cardiovascular exam

2015-02-03T08:55:00.000-08:00

This is the general instructions on how to do a cardiovascular exam

Before you start you would like to:

Wash hands

Introduce yourself and gain consent

Position the patient at 45 degrees

General inspection

Look for paraphernalia

General state

Colour

Short of breath?

Any scars

Make a general statement such as 'Mr X looks alert, well perfused and comfortable at rest

Hands

Tobacco staining

Peripheral cyanosis

Capillary refill time.

Nails - clubbing

Splinter haemorrhages (can be sign of IE)

Nailbed pulsation (a sign of aortic regurgitation (Quinke's sign))

Tendon xanthomata

Janeway lesions (painless) (PROXIMAL IS PAINLESS)

Osler nodes (painful) (both signs of IE)

Arm

Pulse

Radio-radial delay

Radiofemoral delay (can indicate coarctation of aorta or aortic arch aneurysm)

Collapsing pulse or waterhammer (check for pain in arm)(if positive, sign of aortic regurgitation)

Can check brachial pulse

Will give character

Blood pressure (wide pulse pressure indicates aortic regurg, narrow in aortic stenosis) (an easy way to remember this is stenosis means narrowing)

Neck

JVP

Carotid pulse

Examine character

Bounding pulse(CO2 retention)

Small volume (shock, pericardial effusion)

Anacrotic (Aortic stenosis)

Bisferiens pulse (Aortic stenosis & Regurg)

Pulsus alternans (suggets LVF, Cardiomyopathy or aortic stenosis)(alternating weak and strong beats)

Is it visible?

Corrigans sign of aortic regurgitation

Face

Colour - pale flushed central cyanosis

Eyes - Corneal arcus, xanthelasma

Conjunctivepallor

Malar flush (mitral stenosis)

Dentation (Bact endocardititis) check tongue as well.

Praecordium

Inspect chest:

Scars:

Midline sternotomy (can suggest CABG look for graft site at long saphenous)

Lateral thorocatomy (mitral stenosis valvotomy - pretty rare in western world)

Palpate

Apex beat

Note position

Heaving in aortic stenosis or systemic hypertension.

Thrusting feeling in volume overload in eitheir mitral or aortic incompetence.

Tapping in mitral stenosis

Heaves

Thrusting feeling indicating ventriculomegaly (in RV)

Thrills

Palpable murmur

Auscultate

Apex (5th space MC)

Use bell and diaphragm

Can ask patient to roll over to left, breath out and hold to hear mitral stenosis ( mid diastolic murmur)

Mitral regurg is heard as a pansystolic murmur.

Lower left sternum (Tricuspid area)

Sit patient up and listen for early diastolic murmur - aortic regurg

2nd space on left (pulmonary area)

If suspected right sided murmur listen while patient is held in inspiration

2nd space on right (Aortic area)

Listen for aortic stenosis

To complete examination

Palpate sacral and ankle oedema

Auscultate the lung base (for inspiratory crackles)

Examine abdomen for aortic aneurysm and pulsatile liver - seen in tricuspid regurg

Spleen is enlarged with infective endocarditis.

Urine dipstick, Fundoscopy - look for roth spots, Sats, obs and peripheral pulses

Why had four wars not resolved the conflict between the Israelis and the Arabs by 1975? Explain your answer.

2014-07-16T05:56:00.002-07:00

Why had four wars not resolved the conflict between the Israelis and the Arabs by 1975? Explain your answer.

For many years there has been conflict in the Middle East. Neither side has been willing to compromise and after four wars there is still no resolution. In this essay I will be looking at factors in the conflict and addressing how they prevent the Arabs and the Israelis from reaching peace.

The original conflict started well before 1948 with both parties claiming the land and being determined to control all of it. The Jews were being persecuted and treated unfairly all over Europe, they felt the only way to stop this was for them to have a state of their own. In the late 19^th and early 20^th century, many Jews became Zionists and decided that this state should be Israel, the Promised Land God had chosen for them. Similarly, the Arabs also desired to be independent. Previously the Turks and then the British had ruled them; they felt it was finally time for them to take control, but they were also frustrated that they hadn’t achieved this in 1918. Before 1939, Britain was sympathetic towards the Jews and many of them were allowed to immigrate to Palestine. This caused much tension between the two groups of people and this tension reached a climax in 1948 when the Jews took control and declared that Palestine was now the State of Israel. This continued determination to be independent on both sides is evident throughout all the wars and is a main factor that explains why the conflict has not been resolved. This determination is only reinforced by the fact that both sides also lay religious claim to the land.

The first war took place almost immediately and did not do much to resolve the tensions. Instead, it ended leaving the country with a problem of refugees. Over 700,000 Arabs became refugees as a result of the war. Some of them went to neighbouring Arab states but the majority of them stayed in the West Bank or the Gaza Strip. This was the only place not occupied by the Israelis. One of the reasons the conflict has not been resolved is because of this. The Arabs are even more determined to reclaim the land for their refugees. However the Israelis were also determined to control all of Israel, including the West Bank and Gaza Strip. Despite the majority of the occupants of West Bank and Gaza Strip being Palestinian, during both the Suez Crisis of 1956 and the Six-day war of 1967 the Israelis tried to take control of the land. In 1956 they were forced to return it to the Palestinians but by 1967 they had taken control. This is a further reason the conflict was not resolved. The Israelis tried to integrate themselves into the West Bank and Gaza Strip, many of the Palestinian refugees felt they were being treated unfairly and the Jewish settlers were getting the better resources from the government. As a result they wanted the land bank and again became more determined because of this.

However, the Israelis could not have conquered the whole of the land without the help of outside powers and one of the most important factors in explaining why the conflict has not been resolved is due to this. As well as the conflict in the Middle East, the world was also going through a Cold War that involved the two superpowers: America and the Soviet Union. Both the US and USSR heavily influenced what happened in the Middle East and the wars being fought. At the beginning of the conflict both superpowers sided with the Israelis but as the conflict progressed, each gravitated towards one side. In general the Americans supported the Israelis and the USSR showed support to the Arab States and the Palestinians. For example, during the Suez Crisis (1956), Nasser of Egypt went to the Soviets for help and in 1967, the Israelis only attacked when they had the full support of America. Despite this, on one occasion in 1956, the Americans forced the Israelis to retreat from the West Bank and Gaza Strip, as they did not feel the planned attack was right.

However, even though outside countries showed support, it can be argued that they had ulterior motives and by providing arms and support to the parties in the Middle East they were indirectly fighting between themselves. Due to this, the conflict was unresolved as the outside powers were aiming to out do each other rather than actually promote peace. An example of the outside powers looking out for their own interests is the Suez Crisis, where Britain and France used the conflict in the Middle East to achieve their own aims. They had conspired with Israel to overthrow the Egyptians and as a result, they would retrieve the Suez Canal and Israel could conquer the West Bank and Gaza Strip. In contrast to this the UN (United Nations) was an outside power that did try to promote peace. They cam to the aid of both parties and as well providing huge humanitarian help to the Palestinian refugees, they were constantly introducing new peace resolutions. However, neither side could fully agree with any of the resolutions, both sides were unwilling to compromise. As a result, the conflict remained unresolved as both sides still had extreme determination and felt confident due to their powerful allies.

It was perhaps because of the role of outside powers that the conflict was so prolonged. Outside countries aided both the Palestinians and Israelis in all four of the wars and despite this the Arabs appear to have lost all the wars. This is partly due to the disunity of the Arab leaders and this is yet another factor that is accountable for the ongoing conflict. The Arab leaders were not very well organised, they all had the same aim but they did not agree about how to achieve it. For example, King Abdullah of Jordan had originally wanted to control Israel himself rather than allow the Palestinians to be independent. Also, Nasser of Egypt had tried to create a United Arab Republic, which was unsuccessful.

Many Palestinians became disillusioned with the Palestinians government. They had lost all of the wars, they could not agree with each other and still had not resolved any of the problems for the refugees. Also, they had lost control of the West Bank and the Gaza Strip. Due to this many people started to look to other organisations to retrieve the land for them. One of these organisations was the PLO (Palestine Liberation Organisation). The organisation, under the leadership of Yasser Arafat had gained much public support and decided to take matters into their own hands. The PLO thought they could take back control by using violence. They kidnapped and killed Israelis, hi-jacked planes and planted bombs, they were seen by the Israeli government as terrorists. The rise of organisations like the PLO is again another factor that can explain why the conflict was not resolved by 1975 as the Israelis did not want to give in to terrorist threats, they didn’t want to have peace with these criminals and would not submit to them.

There are many factors that can explain why the conflict in the Middle East was not resolved by 1975 such as disunity of leaders, refugees and outside powers. I feel there are two main reasons why the conflict is still a problem. The first is Arab determination and Zionism, both groups believe that the land is rightfully theirs and they are extremely determined and unwilling to compromise. As long as this continues there will be tension and conflict. The second is the role of outside powers. The outside powers seem to be acting for their own interests, while they are still showing support and providing weapons there will be no end to the conflict. The outside powers are prolonging the conflict and by choosing a side, prevent finding a resolution and ever achieving peace.

Religion and science - origins

2013-06-11T04:03:00.002-07:00

“It’s all a question of origins”

The origins of the world have always been a debateable topic with many different views and many sides of the argument. The origins of the world have been argued yet still people cannot come to a final conclusion. Some of these views are explained below.

Scientific ideas

Many people believe in science being the source of the origin of the earth and the rest of the world. Man has always tried to look for the answers for everything independently. Now when the origins of the world are being questioned, humans have got science to get an answer; the big bang. If the big bang theory is scientifically proven then why doesn’t everyone believe in it?

Almost all atheists in a recent survey said that they believed that the big bang theory was correct because it was something that they could relate to unlike God. They said “we can’t imagine what God did to make the world, was it like magic and it just came there.”

The big bang suggests that the world was made from lots of energy starting a big bang this created the first matter. This matter, which was hydrogen, began to compress to produce helium. Some of this matter would become so dense it would ignite and become a star this would create many other elements. When some stars died it created a nova, this used up fuel was normally the source of the planets. Our solar system was made when the sun crashed into a nova. This flung all the different elements at different locations to produce planets.

I don’t agree with this view because the big bang doesn’t say how life was formed. Many people say we were made because all the elements that we are made from are present but what actually made these elements come to life? What made things live? I don’t think that the big bang answers this question.

Religious ideas

The Koran says that if Allah says “be” it is created. The Koran describes how Allah created the world and the heavens and how he made all creatures swim, fly, walk or crawl on the face of the earth. He made the angels the sun the stars and the universe. Allah poured the rain and broke up the ground to bring the corn and the grapes and all other vegetations. He then ordered the angels to bring him lots of soil so he could make man. Allah then made man and women and called them Adam and Eve he made them take care of the animals.

A recent counter argument to this from atheists was that if Allah says ‘be’ and it is created why did he need soil for the creation of man? A recent Islamic belief is that God created the big bang. This ties in both ideas about science and religion however not all Muslims believe this.

The Hindu’s view suggests that the before time began there was nothing except for water (similar to the Christian view) and Lord Vishnu lay on this water with a giant cobra.

With lots of energy Vishnu awoke (this is a link to the big bang as it started with energy). From Lord Vishnu’s navel grew a big lotus flower and in the middle was Brahma the God of creation. Vishnu told Brahman to create the world.

Vishnu then disappeared but Brahma began to create the world. He split the lotus flower into three making one the heavens, one the earth and one the skies.

At this time the earth was bare so Brahma set to work. He created

Plants of all kinds and gave them feeling. Next he created the animals and the insects to live on the land. He made birds to fly in the air and many fish to swim in the sea. To all these creatures, he gave the senses of touch, smell and sight and allowed them to move.

This account shows the religious side as the world was made by a God in this case Vishnu and also the scientific side as it says how the world was made with lots of energy during the awakening of Vishnu to create the world.

My own view

I am a devout Christian and agree with the Christian views, as it seems the easiest to relate to. I can’t imagine the world being created from a big bang. How does the world look so beautiful? It can’t be the product of an explosion. I think that the Islamic view is ok as it does show that the world was definitely made from God and I agree with some of its aspects. I am sure that the world was made by a God as there is no way that the world could have been made by anything else. How did energy produce life? Does a bang just suddenly produce nothing into something? With the Hindu’s view I can understand how they believe that God made the world, which I agree with but an interesting thing is that they include the point of energy which suggests that it has some concurrence with the big bang theory.

As a Christian I believe that God made the world by making it in days with water just being there all the time. On the first day he separated the light from the darkness and called the light day and the darkness night. On the second day he made an expanse to separate water from water. He called the expanse sky. On the third day he gathered the water to one place and dry ground appeared he called the ground land and the water sea. He made the land produce vegetation. With trees that bare fruit. On the fourth day God made the sun to govern the day and the moon to govern the night he also made the stars. On the fifth day God made the sea creatures to roam the seas and the birds to roam the skies. He was pleased with it. On the sixth day God created living creatures to live on the land. He made all sorts of creatures. He then made in an image of himself man so that they could rule over all the earth, and over all the creatures. He created both male and female and he blessed them. On the seventh day he rested. This is a controversial view, as it doesn’t agree with many things to do with science. However it does say how the world was created. And it suggests that God made it; which I think is the most important thing.

Many of the atheists that I know and have asked say that the creation story from the Islam, Hinduism and Christianity are too farfetched and they can’t relate to them, as they can’t understand what God did to make the world. But I think that it is the only solution for the creation of the world it is the only answer and I don’t see why anyone can think otherwise.

I believe that the big bang theory is not fully correct. I don’t think that a bang suddenly created the world. What caused the big bang? Why is it that life was made? I think that the big bang is not the correct answer. I think that there must be a God, but people try to be independent so they use science to get their answer. I think that we have the freedom to choose how the world was made and this means there will be a number of conflicting ideas.

Everyone has the right to chose what they want but really why would you believe that we everything around us is a product of a bang. If we are a product of a big bang there must have been some sort of external influence (God) that caused us to exist. I understand how people believe in the big bang yet I don’t understand how they don’t believe in God.

The inspector calls and how it relates to biblical parables.

2013-06-11T04:03:00.000-07:00

The Parable of the Sower, The Good Samaritan, The Prodigal Son

The Parable Of The Sower

There was a farmer who went to sow some corn. He scattered the seeds in the field and the seeds fell in various places. Some of the seed fell on the path where it was eaten by birds and stepped on. Some of the seed fell on rocky ground, and the plants sprouted but dried up because the soil had no moisture. Some of the seed fell in a thorn bush and grew up but were choked by the thorns. Lastly some seed fell on good soil and the plants grew and produced lots of grains.

Jesus then explains the parable and says:

The seeds that fell on the path represent those who hear, but the devil comes and takes the message from the hearts and stops them from being saved.
The seeds that fell on the rocky ground represent the people who except gods message gladly but it doesn’t sink in and when there faith is on the line they fade away
The seeds that fall among thorn bushes represent the people who hear the word of god but the riches and pleasures of life choke them.
The seeds that fall on the good soil represent the good people who hear the word of god and absorb it and have an obedient heart and they do good things.

The Good Samaritan

The parable of the Good Samaritan is a response to one a Pharisee came to Jesus and asked who is my neighbour? Jesus then said there was once a man who was travelling from Jerusalem to Jericho but then robbers attacked him, beat him down, stripped him and left him half dead. After a while a priest came along on that same route from Jerusalem to Jericho and he saw the man and he didn’t want to get involved so he just walked on by on the opposite side of the road. Next a Levite (a Levite is a high person in Judaism and is someone who helps read the scripture) walked by and looked at the injured man and saw that he needed help yet walked by because he didn’t want to get involved. Then a Samaritan came by and saw the Jew on the floor (Jews and Samaritans weren’t very friendly with each other and should a Jew see a Samaritan he would walk on the other side of the road.) the Samaritan poured oil on the Jew’s wounds and bandaged them, took the man to an inn and paid for him. In case more money was needed the Samaritan said he would pay him next time he comes round.

The Prodigal Son

This parable is about a father who had two sons and the younger of the sons asked father for his share of the property now. The father was very sad but gave the younger son half of the property. After a few days the younger son sold his half of the property and fled to a distant land with lots of money. This younger son wasted his money and spent it recklessly. Then the younger son was forced to work in a farm and wished that he could get even the food that the pigs were getting. The younger son came to his senses and said that even my fathers servants get more food and do not get hungry.

So he got up and went to his father.

While the younger son was a long way from the house the father saw him and ran out and greeted him and hugged him. Then he told his servants to kill the prize calf and cook it and have a big party for his son had come back alive. The older son who had been working in the fields heard the music so he asked one of the servants what was the meaning of this. The servant said your brother has come back. He was furious! The older son went to his father and said all these years I have worked long and hard, never disobeyed your orders and you have given me nothing not even a calf to share with my friends but for this other son of yours who sold half your house you kill the prized calf for him. The father then replied my son, what is mine is yours and you have always been with me but we have to celebrate for your brother is dead and know is alive.

How the parables could be related to the inspector calls

I think that the parable of the sower is related to the inspector calls through the various types of seeds. I think that the seed that fell on the path represents Mr and Mrs Birling who know what is right and what is wrong but they aren’t sorry for what they did and wouldn’t change what they did if they had the chance to. I think that the seed that fell amongst the thorns represents Gerald as he wants to do what is right but in the end he is sorry to Sheila and not to Daisy Renton.

I think that the good Samaritan is related to the inspector calls through the fact how Mrs Birling who was supposed to be someone who is helping the poor rejects Eva smith just like how the priest or the Levite did. I think it could be related to the inspectors speech in which he says there are thousands of Eva smiths… and I think that because when the family realise that Eva smith didn’t die they don’t feel any remorse and they don’t care about the thousands of other Eva smiths in the world or you could say they don’t care about the thousands of other injured Jews.

I think that the parable of the prodigal son could be related to the inspector calls through Eva smith. Eva smith asked for extra wages just like the younger son asked for his share of the properties (under different circumstances). After Eva smith left Mr Birlings Company she had a nice life working at Millwards just like how the younger son was happy with all his money when Eva smith loses her job she gets herself in trouble just like when the famine came the younger son was in trouble. When she goes back to Mrs Birling she receives nothing the only contrast is that the younger son goes to get help and he does receive his fathers love.

To what extent was Jesus a pacifist?

2013-06-11T04:00:00.002-07:00

To what extent was Jesus a pacifist?

To make a decision on whether Jesus was a pacifist must first clarify what i mean when we say pacifist. A pacifist is someone who believes violence is not the answer to solving problems. A pacifist feels that war is destructive, murderous and unnecessary. A pacifist would rather rely on negotiation, diplomacy and empathy to achieve resolutions to problems. Pacifists can often be split into to groups, Total Pacifists, people who would never use violence under any circumstance and Partial Pacifists, people who believe that violence should only be used as a last resort in self defence. Now that I have clarified what a pacifist is, I must compare how Jesus is shown in the bible and compare it with this definition of a pacifist.

One of the arguments for Jesus being a pacifist is because he said: “Blessed are the peacemakers for they will be called the children of God” in the Gospel of Matthew. This would suggest clearly that Jesus is a pacifist as he is promoting peaceful behaviour and says how it is rewarded in the Beatitudes. Another occasion where Jesus shows that he would be a pacifist is in the garden of Gethsemane before he was arrested, “When Jesus’ followers saw what was going to happen, they said, ‘Lord, should we strike with our swords?’ And one of them struck the servant of the high priest, cutting off his right ear. But Jesus answered, ‘No more of this!’ And he touched the man’s ear and healed him.” This shows that once more Jesus was against violence and tells of Peter for attempting to defend Jesus.

On the other hand, Jesus could be perceived as someone who is not a pacifist. This is reflected in his behaviour in the temple, when he drives out the money changers. “Jesus entered the temple area and drove out all who were buying and selling there. He overturned the tables of the money-changers and the benches of those selling doves. ‘It is written,’ he said to them. ‘My house will be called a house of prayer, but you are making it a den of robbers.’ ”. This would clearly show that Jesus was very angry and would suggest that he is not a pacifist as he himself is participating in an act of violence. This would suggest that Jesus feels that violence is ok and can be tolerated if it is for the right reasons. However although Jesus did drive the money-changers out he did not actually attack the money changers themselves and did not harm them and it could be argued that Jesus was only destroying the idea of people running the temple like a business.

Although there is much evidence that would suggest that Jesus is not a pacifist there is further evidence to suggest that he is a pacifist. This is on the Sermon on the Mount when jesus says, “You have heard that it was said, 'An eye for an eye, and a tooth for a tooth.' But I tell you, do not resist an evil person. If someone strikes you on the right cheek, turn to him the other also. And if someone wants to sue you and take your tunic, let him have your cloak as well. If someone forces you to go one mile, go with him two miles. Give to the one who asks you, and do not turn away from the one who wants to borrow from you.” Many people would argue that this quote promotes total pacifism however because of the earlier act of violence shown by jesus many people would conclude that overall jesus would be a partial pacifist and is not fully a pacifist as he himself used violence to drive out the tax collectors and money changers in the temple.

What were the most significant WW2 battles?

2013-06-11T03:59:00.003-07:00

What were the most significant WW2 battles?

There were no insignificant battles in the war. However, there is clear proof that particular wars are more significant then other wars. The wars that would be classified as significant are the wars that are the most important and caused the most impact and maybe change the course of a whole war.

Many historians have described Stalingrad as the turning point of World War 2. It has been described as the Hitler’s demise. The war began with the axis powers heading into the Soviet Union (which at the time was classed as a superpower) on June 22^nd 1941. The axis powers tried to siege the Russian city, Stalingrad. The war was the soviets against the Nazis and its allies (Romania, Italy, Slovakia etc.). Stalingrad was an industrial city and it also held the name of his rival Stalin. Stalin realised this and forced anyone who was able to hold a rifle to fight. This is seen as one of the most significant battles of World War 2 because Hitler lost 850,000 men. This is a quarter of the men fighting in the western front. They also lost a significant amount of supplies that they couldn’t recover. They were forced to retreat out of Eastern Europe causing the collapse of the Nazi empire. Stalingrad is arguably ‘the bloodiest battle in human history’.

Pearl Harbour is known for Japan’s surprise attack on America to cause immense destruction on Pearl Harbour. Pearl Harbour was a military bas in Hawaii. It was the base for the US Military action in the pacific. On December 7, 1941 the Japanese completely destroyed Pearl Harbour with dive bombers and fighter planes. The Americans were very angry with this and President Franklin Roosevelt declared war after Pearl Harbour. On December 11, 1941 Germany declared war on the US as Japan and Germany were in alliance. The attack on Pearl Harbour caused the Americans to lose 21 warships, 177 planes (on the ground) and over 2000 men. The Japanese lost only 29 planes and 100 people which seems a small price to pay for the damage dealt to the US. The main significance of the battle is that the US were involved in the war and that they declared war on Japan on the 7^th December and the axis powers declared war on the US on 9^th December.

Hiroshima and Nagasaki are best known for the droppings of atomic bombs. August 6, 1945 an atomic bomb was dropped on Hiroshima and on august 9, 1945, an atomic bomb was dropped on Nagasaki. The droppings of the bombs forced the Japanese to surrender and they had no option as they thought the Americans had more atomic bombs (even though the Americans only had 2 atomic bombs). The Americans believe that the bombings prevented the deaths of many people from both armies. The Japanese think otherwise. The bombings of Hiroshima and Nagasaki were the finishing part of the war that lead to the surrender of Japan and it is significant due to the impact that it had on Japan. As well as 214,000 people dying from the explosion the radioactive particles gave the bomb its venom. Many people were killed by the effects of radiation a long time after the war and at the time no one knew how severe the bombings were and how to cure or improve the conditions from radiation exposure. Due to the sheer power of the atomic bombs the Japanese were forced to surrender as they could not sustain another blow from an atomic bomb which gives this battle its significance as it ties up Japan and removes them from the war.

It would be foolish to say that any of the wars in world war 2 were insignificant but I have chosen these three wars to be the most significant because of the impact that they caused (especially Hiroshima, Nagasaki and Pearl Harbour) also the loss of men contributed to the significance for these wars and also in terms of the war Stalingrad was seen to be the bloodiest war ever and the turning point in the war. Pearl Harbour led to the introduction of the US and this lead to Hiroshima and Nagasaki. Hiroshima and Nagasaki was the major blow that forced the Japanese to surrender. For these very reasons I would say that the three most significant battles were Stalingrad, Pearl Harbour and Hiroshima and Nagasaki.

How did the world begin?

2013-06-11T03:58:00.002-07:00

The creation of the world has always been a debateable topic. It has brought up many ideas and points of argument. It is one of the key questions in life and it is answered by almost all religions. It is one of the fundamental questions that can be the foundation of many people’s faiths. Another opinion is that the world was made from the big bang which is a big explosion which is sciences view.

The big bang theory suggests that energy has always existed. Before time there was a massive amount of energy. Fifteen billion years ago (the estimated beginning of time) there was a ripple in this energy this expanded rapidly causing the beginning of time and the big bang.

Matter began forming after 300,000 years with the first forms being what we call ‘particles’ there are three types of particles; protons, neutrons and electrons. Gravitational forces caused atoms to become attracted to each other. The early atoms were hydrogen. A minute amount of this hydrogen fused together to produce helium.

Star birth begins with the ‘ignition of a star’. All the hydrogen and the minute amount of helium become so dense and hot that it begins to ignite. The ignition temperature is twenty million degrees Fahrenheit. During this ignition heavier elements are created and nuclear reaction takes place.

Our sun is a star and is made through star birth however there are mixed opinions for how the solar system with all the planets were made. One of the theories is that our sun crashed into a nova which flung out material at different differences from the sun causing planets. Of one is our earth.

The earth was a hot molten mass. When it cooled the lighter material came up and made the crust of the earth. The water vapour was in the atmosphere and when it cooled down and it created the oceans.

The big bang suggests in a scientific manner how the world was made but what about how life was made? It does not say what actually brought life into the world which is one of the problems with the big bang theory. However it has been argued that many scientists know how life comes into the equation with the big bang however no one can actually be sure as all of these ideas are just theories like the big bang and are just educated guesses.

The Christian view is that god exists and that he created the world ex ni-hilo. That means he created the world from nothing. Christians believe that god created the world in seven days.

It is believed by Christians that on the first day God created light; he separated the light from the darkness and called the light day and the darkness night. At the start of the bible it says that god was hovering over the water but it doesn’t explain how water was made. But it does tie into how water is an essential part of living. It has also been argued that he could have possibly become the waters.

On the second day he made an expanse to separate water from water. He called the expanse sky.

On the third day he gathered the water to one place and dry ground appeared he called the ground land and the water sea. He made the land produce vegetation. With trees that bare fruit.

On the fourth day god made the sun to govern the day and the moon to govern the night he also made the stars.

On the fifth day god made the sea creatures to roam the seas and the birds to roam the skies. He was pleased with it.

On the sixth day god created living creatures to live on the land. He made all sorts of creatures. He then made in an image of himself man so that they could rule over all the earth, and over all the creatures. He created both male and female and he blessed them.

On the seventh day he rested. This is a controversial view as it doesn’t agree with many things to do with science. However it does say how the world was created.

The Hinduism view suggests that the before time began there was nothing except for water (similar to the Christian view) and lord Vishnu lay on this water with a giant cobra.

With lots of energy Vishnu awoke (this is a link to the big bang as it started with energy). From lord Vishnu’s navel grew a big lotus flower and in the middle was Brahma the god of creation. Vishnu told Brahman to create the world.

Vishnu then disappeared but Brahma began to create the world. He split the lotus flower into three making one the heavens, one the earth and one the skies.

At this time the earth was bare so Brahma set to work. He created

As a Christian I believe in the Christians view of creation although I do not think that the way the world is created matters as much as many other things. I can see why many people believe in the big bang yet I cannot understand how they can think of just the big bang alone. I think that the world could have been made by the big bang and also by god as well because the big bang doesn’t suggest how life was made. The hindu’s view is very interesting because it incorporates similar views as the Christians view (my view) where it says that there was only water. It also incorporates the scientific view as it suggests how lord Vishnu woke up with energy and similarly the big bang started with energy.