The Role Of The Catholic Religious Education Specialist Teacher Article

The Role Of The Catholic Religious Education Specialist Teacher - Article Example Religious education encompasses various areas such as evangelisation, catechesis, giving witness, introduction to church, prayer, experience of faith, and knowledge of other faiths. At the same time, the Religious Education specialist teacher’s duties need to be performed on the basis of what the Catholic church teaches; what the government states: the curriculum for excellence; and what schools expect from them in the context of any extracurricular duties which are not expected of other teachers in the school. Thesis Statement: The purpose of this paper is to investigate the role of the Catholic Religious Education (RE) specialist teacher, the various areas of religious education, and the influence on the RE’s role by the Church, the government and the school. Religious teaching can be understood as a ministry with a professional dimension (Cook & Hudson, 2006). Catholic educators need to think and act sentire cum ecclesia which refers to the ideal form of thinking and feeling with the church on the basis of individuals’ identity as Catholics. ... ng to Cook & Hudson (2006: 399), assessment of religious teaching as a profession can be based on a framework composed of the following characteristics: "essential service to society, motivation by a call to serve, special knowledge and skills, specialized and advanced university training, public trust and status, code of ethics and performance standards, and professional organization".Religious Education helps in students' development of the self, socially, morally and spiritually (SCAA, 1994). Research conducted by Sikes & Everington (2001) indicates that a religious education teacher's life history plays a vital part in determining their teaching skills and approach to work. Further, "the quality, range and flexibility of teachers' classroom work are closely tied up with their professional growth - with the way they develop as people and as professionals" (Hargreaves, 1994: xi). This evidence would be useful in screening potential candidates for training as RE specialist teachers, by addressing negative identities unsuitable to carry out the important work. Evangelisation and Catechesis Ecumenism is the essential task of the whole Church to bring the Gospel to the entire world. Ecumenism and mission, evangelisation and Church community converge in a common witness to the same God (Houtepen, 1998). The Church's evangelistic mission is expected to be carried forward by the RE instructor by imparting the Faith to all students in the classroom, including those students who do not share the Christian faith, in the interests of sharing the wisdom and benefits of the Catholic religion (Francis et al, 1996). Teachings of the Catholic Church are mainly through catechesis. Bishop O' Donoghue (2008) believes that the key element or essence of the aims of a

U.S. Totalization Agreement With Mexico Essay Example for Free

U.S. Totalization Agreement With Mexico Essay The focal point of this paper is to analyze the Totalization Agreement between the US and Mexico. It should be noted that the aspects of this analysis is not fundamentally policy analysis but it intended towards presenting arguments from the point of view of analytical framework. In this paper there would not be any bias or opinion presented rather a comparison would be presented in terms of arguments for and against the issue. It should be stated that in the context of globalization the Totalization Agreement is a very important aspect for the US. Totalization Agreement has the tendency of investment funds and businesses to move beyond domestic and national markets to other markets around the globe, thereby increasing the interconnectedness of different markets. Globalization better said is the shift in the direction of a more incorporated and interdependent World economy. Globalization has had the effect of markedly increasing not only international trade, but also cultural exchange. some intellectual define globalization as convergence of prototypes of manufacture and expenditure and a consequential homogenization of customs, while others strain that globalization has the prospective to take countless miscellaneous appearances. In economics, a wide description is that globalization is the union of prices, wages, products, profits and rates of interest in synchronization with developed nation norms. Globalization of the financial system depends on the position of international business, human migration, incorporation of pecuniary markets, and mobility of capital. The International Monetary Fund observes the increasing financial interdependence of countries all over the world through rising quantity and multiplicity of cross-border dealings, gratis international capital flow, and comparatively faster and extensive dissemination of technology. In contemporary economic scenario the prevailing trend is expansion in the global market. Global market expansion is nothing but a concept of serving customers beyond the limits of domestic market and in economic scenario considered a key growth strategy. Global market expansion is a business reality that every company encounters at some point in its evolution. Under such circumstances every business venture must balance risk with rewards, the risks when expanding internationally can be less predictable and in the same way the rewards can be more elusive. The companies, which are looking for sustainable ways to grow and diversify their revenue streams, consider global expansion as a strategic option. There are several factors behind the trend toward expansion in the global market. Companies require a global presence. For both offensive and defensive causes, companies cannot overlook opportunities outside their home markets. A company’s requirement for a global presence arises from two factors, their capability of leveraging domestic relationships outside their country and a requirement from domestic customers to support the company’s products internationally. A global expansion allows companies to replicate successful domestic strategies in international markets, potentially in markets with lower competitive intensity. Additionally Global market expansion provide the companies large untapped markets, advantages of low labor costs, savings of shipping costs, speed and efficiency of delivery system, etc. These factors make the Totalization Agreement between the US and Mexico more important. (Fletcher, 2006) The Totalization Agreement between the US and Mexico could be better understood in the light of the history behind it. For more than thirty years US has been establishing agreements relating to social agreement internationally keeping in mind that these agreements should coordinate with the program by the Social Security of the US. These agreements based on the aspects of programs related to Social Security of the US are cumulatively pronounced as totalization agreements. Under these agreements there are certain advantages. However, from the point of view of the US these advantages can broadly be divided into two parts. The first objective is to eradicate double taxation for workers employed in foreign nations. Without the agreement an individual would have to pay two times as tax on the earnings. The current report suggests that the benefit of Totalization Agreement between the US and other countries has help US workers working abroad at lot. The cumulative savings are estimated at $800 million per year. The second objective of Totalization Agreement between the US and other countries is to provide an individual who is part timer as a worker in either in the US or the foreign country the proportional tax benefit that is so important for the worker. In this context the agreement between US and Mexico becomes very important in the context of financial benefits. It has been estimated that once the agreement of Totalization is signed between the US and Mexico the workers from the United States in Mexico would be able to save about an estimated $140 million. These savings would be made in the parameters of Mexican taxes relating to health insurance and social security measures. However, it should be mentioned that this estimation is calculated on the basis of a 5 year term of computation. Again, in the perspective of humane benefit it would immensely help the workers who have been working in Mexico for a shorter period of time in both US and Mexico as because this agreement would help them to receive the benefits. (King, 2006) It could well be stated that Mexico is a prominent partner of the US in terms of trading. In fact it is the second largest after Canada. This way it becomes important for the US to indulge in Totalization Agreement with Mexico. As it is Mexico is already under the Totalization Agreement with Canada making it mutually beneficial for both countries. The advantages and disadvantages of Totalization Agreement with Mexico have been heavily scrutinized and debated in recent years. Proponents of Totalization Agreement with Mexico say that it helps developing economies catch up to highly developed industrialized economies much faster through increased employment and technological advances. Critics of Totalization Agreement argue that it weakens national sovereignty and allows rich nations to ship domestic jobs overseas where labor is much cheaper. The main advantages of Totalization Agreement are as such, increased free trade between the two nations, increased liquidity of capital allowing investors in developed nations to invest in developing nations, conglomerates are having greater flexibility to operate across borders, global mass media binding the world together, increased flow of communications allowing vital information to be shared between individuals and conglomerates through out the globe, greater facility and speed of transportation for goods and people, reduction of cultural barriers increases the global village effect, spread of democratic ideals to developed nations, greater interdependence of nation-states, reduction of likelihood of war between developed nations , increases in environmental protection in developed nations. Along with the advantages there are also several disadvantages of Totalization Agreement, such as increased flow of skilled and non-skilled jobs from developed to developing nations as companies look for the cheapest labor, increased probability of economic disturbances in one nation effecting all nations, business influence of nation-states far exceeds that of civil society organizations and average individuals, apprehension that control of world media by a handful of conglomerates will limit cultural expression, greater possibility of reactions for globalization being violent in an attempt to conserve cultural heritage, greater danger of diseases being transported inadvertently between nations, spread of a materialistic lifestyle and outlooks that sees consumption as the path to affluence, international bodies like the World Trade Organization interfere with national and individual sovereignty, increase in the probabilities of civil war within developing countries and open war betw een developing countries as they compete for resources, decrease in environmental integrity as polluting corporations take advantage of weak regulatory rules in developing countries like Mexico. It could well be stated that in this competition organizations are gradually loosing their ethnic values and morals. Today competence of an individual or a corporate is judged by his or her ability to cope up with constant fundamental changes in the organizational structure. All over the world, organizations aligning new products engineering teams around ‘pit crew’ model. Cross functional teams to design, manufacturing sales and service engineer’s work along with the workers, who at some point of time have stake in the product. This ensures manufacturing and sales people having their say all through the design process and building up the manufacturing capability early on that is currant engineering. The goals are simple, such as speed, equality and competitive price. Commodities have become international for most industries and the impact of engineering is significant. In many organizations, the learning curve in engineering has become an unaffordable luxury. Competitive pressures mandate finding ways to reduce the total time required to introduce new products in the market. Competition along with more complex production and distribution environments requires identifying and reducing necessary costs, such as costs associated with development, manufacturing, distribution and service. However, it can be stated that totalization agreement would have a distinct effect on the Trust Funds but it would be a long termed and virtually negligible effect. It has been estimated that the social security of US bears a cost of about $100 million yearly. This has been the trend for the last 5 years. Thus the totalization agreement would enable the workers of both the US and Mexico to enjoy the advantage of cost benefit as the dual taxation would be eradicated. It should be mentioned in this perspective that the cost benefit of US during the year 2002 was around $198 million with Canada alone under the parameters of the totalization agreement. (Lamb, 2004) Thus in the conclusion it could be stated that there are both advantages and disadvantages in coming into a condition of totalization agreement with Mexico. However, when an international agreement is signed there are multiple aspects to be looked after and these are done keeping in mind the mutual benefits of the nations. References: Fletcher, R; (2006); Beliefs and Knowledge: Believing and Knowing; Howard Price King, H; (2006); Social Security Today; HBT Brooks Ltd Lamb, Davis; (2004); Cult to Culture: The Development of Civilization on the Strategic Strata; National Book Trust.

The Use Of Mechanical Ventilators Engineering Essay

The Use Of Mechanical Ventilators Engineering Essay The respiratory system, composed of different structures, is involved in ventilation and gas exchange. Its main function is to provide a surface for gaseous exchange of oxygen and carbon dioxide [1]. Gas exchange is performed at the alveoli, specialised cells which are part of the lung parenchyma. It provides oxygen to the blood and removes the carbon dioxide produced in the body as a product of cellular metabolism; for the oxygen to reach the lungs there must be a series of tubular structures that communicate with the outside. The diagram below shows a block diagram of the anatomic structure for the respiratory system (Fig. 1). Figure Block diagram of the Respiratory System anatomic structure Air diffusion into these channels is conducted by the respiratory muscles (intercostals and diaphragm) which increase and decrease rhythmically the size of the thoracic cavity (inspiration and expiration). The pleural cavity contributes on this phenomenon when its negative pressure opposes the elastic recoil of the lung; this action gives place to a conductive portion of the system, whose function is to allow air penetration. In addition the respiratory portion composed bronchioles, alveolar ducts, alveolar sacs and alveoli; establishes homeostasis. Figure Muscles and Pressures involved during breathing The ventilation of the lungs can be measured by studying a gas volume and its variations in the lungs [2]. Boyles, Charles, Daltons and Henrys law of gasses are critical in the understanding of gas exchange, measurement of gas movement take an important part in mechanical ventilation. During breathing movements are cyclic, and volume in the thoracic cavity is changed by the muscles mention before. During inspiration the pressure within the thoracic cavity and lungs is decreased and the same time the volume is increased, allowing air flow in. On the other hand during expiration the elastic lungs and the thoracic wall recoils producing an increase of pressure but a decrease in volume; allow letting air flow out (Fig. 1). Figure Respiratory performance and volume relationships Figure 3 At the same time, inhalation and exhalation allow the mobilization of the volume of gas which can vary depending on the type of respiratory movement and lung elastic forces. Lung capacities are defined by the sum of different volumes. Figure 2 shows a graphic representation of the respiratory performance volume relationships. FCR (Functional Residual Capacity) represents the remaining air after a cycle. VT (Tidal Volume) is the flux of air in a normal inspiration and expiration. IRV (Inspiratory Reserve Volume) is the amount of air moved during a maximum and forced inspiration and results over the Tidal Volume. Similar to IVR, ERV (Expiratory Reserve Volume) is the amount of air mobilised during a maximum and force expiration resulting below the Tidal Volume. The vital capacity is the sum of IRV, VT, and ERV. VR (Residual Volume) as its name says, is the amount of air remained in lungs after a maximum exhalation. The IC (Inspiratory Capacity) is the flux of air after a quiet cycle. A nd finally the TLC (Total Lung Capacity) corresponds to the total volume of gas remaining in the lung after a maximal and forced inspiration. Volumes and lung capacities may be altered in different diseases; its measurement is a critical element for diagnosis, performed by pulmonary function tests. The respiratory parameters: compliance, lung elasticity, intrathoracic pressure, airway resistance, intra-alveolar pressure; help measure the strength in muscles when breathing. Airway resistance is determined by the Poiseuille Law (eq. 1): {1} Where ÃŽÂ · represents the viscosity of the fluid, l is the longitude in the airways, and r is the radio on the airways. Resistance has a great significance in pulmonary physiology; and it is analysed by the ratio of the pressure differential flow. The airway resistance can be increased significantly in the presence of disease such as Bronchitis, Asthma, and Emphysema among others. In addition a great amount of patients admitted to intensive care have need of some form of respiratory support; due primarily to hypoxaemia or ventilatory failure. Respiratory support ranges from oxygen therapy by face mask, through non-invasive techniques such as continuous positive airways pressure, to full ventilatory support with endotracheal intubation[3]. Figure Block Diagram of a basic mechanical ventilator A mechanical ventilator is an automatic machine, designed to provide all or part of the work the body must produce to move air (gas) from the inside to the outside and vice versa. Furthermore mechanical ventilators are designed to transmit energy applied in a predetermined manner to perform a specific task. Interface between machine and patient stable, energy source, control system (for timing and size of the breaths regulations) and monitoring (device performance and patients condition) are the general requirements for ventilators (Fig. 4). A further analysis as well as comparison of this equipment will be made along the paper, with the purpose of a better understanding of its designed and future developments. Current State of the Art Since the invention of artificial respiratory supply, mechanical ventilators have evolved in the past 40 years. There are five generations of mechanical ventilators where changes have been made in order to present a better apparatus. The first generation consisted of only one mode of ventilation, and the electronics used was primitive compared to the one used nowadays. The equipment was no safe since the control with the user was not precise and it did not count with any alarm system. The second generation provided basic alarms, containing electronic circuitry as well as an analogue control of fluid. A major evolution took place on the third generation; digital electronics, microprocessors, were employed for most of the functions. The fourth generation included modern displays such as CRT or LCD ensuring a better patient care. The generation currently used is the fifth generation which features a better onscreen display control. It is also made by advanced logarithms that permit graphic display, calculation of lungs mechanical properties, and system diagnostics. Principles of Operation Mechanical ventilation is all different types of procedures that provide artificial respiration employing machinery to meet the respiratory function of a person who cannot perform it by itself [4]. In addition Mechanical Ventilation (MV) is the product of interaction between a ventilator and a patient, and through this equipment parameters of volume, flow, pressure and time are controlled. Considered as a generator of positive pressure that supplies active phase of the respiratory cycle; there are basically four types of MV: controlled by pressure, time, volume and flow. Mechanical ventilation systems create an intermittent positive pressure where air or a gas mixture enriched in oxygen is insufflated in the patients airway. Pressure in the airway at the end of passive expiration and that at the same time goes beyond atmospheric pressure is known as positive end-expiratory pressure (PEEP) [5]. PEEP is extremely important in effects and mechanisms of the respiratory system. It plays major roles in gas exchange, lung mechanics, and hemodynamic effects. Some effects in lung mechanics it prevents the lung from collapsing, increases FRC among others.[5] In order to provide respiratory support, a MV such as the one in figure is used. Figure Flow and control of gas exchange during artificial ventilation Input of this system provides O2 as a medicinal gas; and in the case of portable ventilators the medicinal gas can be supplied by a dry air compressor. Ventilatory gas is passed through a pressure regulator; which is in charge of preserving the preset pressure for the inspiratory gas and ensures the integrity of the airway. The gas flown to the patient is allocated by an electro-valve (Fig. 5); this remains energised until the end of the inspiratory time previously programmed, when de-energised the gas flow is ceased. Finally the expiratory electro-valve is activated causing the air exhaled by the patient to be expelled to the environment by a biological filter that prevents the contamination of this. Models of Ventilator-Patient Interaction Figure Model representing breathing, were a rigid flow conducting tube is connected to an elastic compartment The Respiratory System can be modelled to illustrate the relations amongst the variables of interest; providing a better understanding of patient-equipment interaction. The model most frequently used is shown in figure where a rigid flow conducting tube is connected to an elastic compartment [6]. When airway pressure goes higher than the base line, the inspiration is assisted (Fig. 6)The Transrespiratory pressure (eq.2) leads inspiration, and is the pressure at the airway opening, ,minus the pressure at the body surface: {2} At the same time has two components, transairway pressure (eq. 3) and transthoracic pressure (eq. 4): {3} {4} A mathematical model that represents volume, pressure and flow during ventilation is known as the equation of motion for the respiratory system [6] (eq. 5) : {5} Where is the pressure generated by the ventilator, is the pressure generated by the ventilator muscles, is the respiratory system elastance, is the respiratory system resistance, and is lung volume where the derivate of volume with respect of time is the flow in the system. Table (1) compares typical values against values during mechanical ventilation [6]. Table Pressures and Volumes during Mechanical ventilation Typical Values Mechanical Ventilation The model provides the basis for monitoring the patients current condition, and it is done in terms of R and E which are mechanical properties. Figure Electrical model representing breathing composed of a RC circuit Another model used for representation is the electrical model (Fig. 7); this model is analogous to an electrical circuit consisting of a resistor and a capacitor (RC circuit), a power supply, which in this case represents the pressure generated by a mechanical ventilator. The electric current stands for the flow of air in the system. In this model, pressure, volume and flow are variables (functions of time) while the resistance and compliance are constant [4]. Second Law of Kirchooff can be used to analyse the electrical model and the following equation(eq. 6) can be derived: {6} Current and charge can be related by , the electrical parameters of the circuit can be now represented by the ventilator variables. When applying a pressure to the input of the system (output pressure of the ventilator), the volume varies according to the following differential equation (eq. 7) the total pressure applied is equal to the sum of the differences in pressure due to the compliance of the system and to the resistance of the airway: {7} According to this system is the output pressure of the ventilator, the inspiratory volume, and is the compliance of the lung [4]. Operating Modes Mechanical ventilators count with different operating modes, which are the manner the ventilator ensures that the patient is provided by the appropriate minute ventilation; satisfying the respiratory needs without damaging any pulmonary tissue. Operating modes can be identified by: breathing pattern, Control type, Control Strategy [6]. When specifying just the breath control variable (Primary Breath Control), there are three approaches: pressure control, volume control and dual control modes. Pressure control (PC) is used when patients can initiate respiration; pressure in the airway is increased during inspiration. Volume control (VC) employs a control system to guarantee that a set tidal volume is distributed during the inspiratory cycle. The Dual Control (DC) is simply a combination of both, used in order to provide minute ventilation while maximizing patient synchrony[6]. Breath sequence is the other component of breathing pattern operating mode. There are two ways airflow can be delivered using this mode, mandatory or spontaneous. The difference between the two of these is that on mandatory breath the ventilator initiates and establishes the tidal volume, Vt. Contrary to mandatory breath on spontaneous breath the patient establishes and starts its own breathing. From these, three different modes of breath sequence can be delivered: Continuous Mandatory Ventilation (CMV), Continuous Spontaneous Ventilation (CSV), and Intermittent Mandatory Ventilation (IMV). CVM and CSV, all breaths are mandatory or spontaneous respectively; however in IMV breaths can be either mandatory or spontaneous [6]. Controls In order to select breathing mode and ventilation pattern parameters, controls are used. There are two different ways on which breathing can be controlled, and at the same time there are control strategies which depend on the variables and parameters set to obtain this. A system can be controlled by an open loop or closed loop (Fig. 8). Like any open loop system, there is no feedback, and the system could be affected by mechanical changes in the lungs, patients ventilatory efforts and leaks [6]. Figure Control systems used for mechanical ventilation Closed loop sense breathing variables such as pressure, volume, and flow to provide a feedback signal which is compared to the desired value set at the input. There are different types of closed loop systems depending on the number of variables used. The instruments used to measure volume-flow rate are referred to as volume flowmeters; they may be classified as rotameters, penumotachographs, hot-wire anemometers, time-of-flight flowmeters, ultrasonic flowmeters, and vortex flowmeters [2]. Depending on their principle of operation, flowmeters can be classified in four main categories: rotating-vane, ultrasonic, thermal-convection, and differential pressure flowmeters. Rotating-vane Flowmeters These types of sensors contain a small motor or turbine which rotates with airflow, and then flow rate is related to the revolution of the rotor. This type of flowmeter is commonly used in ventilator machines and respiratory monitoring [2]. The spins are detected optically and converted into voltage to be recorded or displayed. Ultrasonic Flowmeters Ultrasonic flowmeters can measure instantaneous flow and the effect of the flowing gas on the transit time of the ultrasonic signal [7]. A crystal is used for transmitting and receiving and it is placed externally and obliquely to the axis of the tube through which the gas flows [7]. The time elapsed will depend not only on the velocity, but on the temperature as well as composition of the gas analysed. One main advantage of this type of transducer is that unidirectional flow can be measured, which is applicable for clinical monitoring. Thermal-Convection Flowmeters Thermal sensing technologies are usually made of hot wires, metal film, and thermistol which all use heat to sense gas flow. The wires are heated by an electric current and the heat transfer is used to measure the gas flow [2]. The wire is heated above flow gas temperature, to associate temperature differences; a metal mesh is placed at both ends of the tube. This type of sensing is limited to only one flow direction, more sensors can be located in the tube for multiple directions and for breathing a calibration factor must be considered. [7]. Differential Pressure Flowmeters Flowmeters that use the relationship of pressure drop with airflow through a system. There include elements such flow resistors. Common Failures Figure Closed system during mechanical ventilation The most common failures presented in MV are mainly as a consequence of poor maintenance and user error. Leaks in the circuit due to bad connections or due by perforations in tube are a frequent dysfunction. Leaks stop the proper delivery of tidal volume as well as an accurate sensing flow from the ventilator. PEEP can also be affected by this interfering with O2 saturation (Fig. 9). At times, when an patient with intubation is not able to trigger the ventilator, or the ventilator senses by mistake a patients effort and delivers breaths, is known as patient-ventilator dyssynchrony. As a result the machine delivers an unsuitable breath to the rate of the patients inspiratory efforts. This type of error is also identified as trigger failure or desynchronisation, mismatching, and fighting the ventilator [8]. One cause for patient-ventilator dyssynchrony is fixing the trigger sensitivity improperly. When a desynchronisation with the patients efforts to initiate a breath exists, work of breathing can occur which can be accompanied with respiratory distress preventing pulmonary gas exchange.. Another usual failure is due to user error with the interface. MVs are complex equipments, and the need of the clinician to be familiar with the machine is crucial. It is important that Mechanical Ventilators count with an audible and visual alarm when detecting a leakage or disconnection. Possible hazards to humans Problems may occur while using a mechanical ventilator, especially with patients that been required the use of a MV for a prolonged amount of time. The risks occasioned by the use of respiratory support can lead to severe harmful or even death. Common hazards that may occur due to the use of a ventilator are: infections, pneumothorax, and lung injury. Infections The most common risk reported is acquiring Ventilator-associated pneumonia, which is caused by an infection. The tube allows germ (bacteria) to penetrate more easily into the lungs. This can cause pneumonia. Pneumonia can be a serious problem and may mean that a person may not be able to initiate respiration leading to a longer use of a MV. In addition a recent study reported factors related such as the development of shock, and renal failure [9]. In order to prevent infections a number of control procedures can be performed, and these include maintaining the ventilator as well as the breathing circuit [8]. Pneumothorax Occasionally when a part of the lung is weak, this may become over full of air and as a result an air leak may occur. The leak allows air into the space between the lung and chest wall. The air in this region occupies space in a manner that the lung begins to collapse. If there is air leakage, a chest tube into is used to drain the excess air; allowing the lung to re-expand and stop the leak. Lung Injury The pressure generated by introducing air into the lungs with a ventilator can damage the lungs. Furthermore, very high levels of oxygen can also be harmful to the lung. As a solution to try to keep this risk to a minimum the lowest pressure necessary as well as the only oxygen needed is supplied. Prolonged intubation usually defined as a period longer than 48 hours [10] may lead to swallowing dysfunction. This is mainly caused by impairing glottic closure reflex, reducing subglottic pressure, limiting laryngeal elevation, desensitizing the larynx and hypopharynx, and causing disuse muscle atrophy of the larynx and pharynx [10]. Advantages and limitations of various techniques Once analysed the principles of operations and risks of Mechanical Ventilators, for a better understanding of these is necessary to mention the advantages and disadvantages that they could bring. The impact MV have had over the past 40 years is massive due to the fact that mechanical ventilators provide vital support. Nowadays ventilators found in the market present vast options in terms of modes, control and displays which in many cases can result complicated and the knowledge of these is required[8]. In addition features need to be evaluated in order to establish which configuration mode is suitable for each patient [8]. Ideally hospitals should acquire equipment that incorporates the latest development in ventilation; however as mention before this could lead to complications and misuse of the devices. Requesting companies training to all staff involved in the use, handling and care of the equipment helps to reduce the risk [11].The complicity of the equipment could be considered as a disadvantage of MV, nevertheless ventilators with good human factors design provide major advantage [8]. Mechanical ventilators, being devices that provide respiratory support the duration and need may vary from patient to patient; age is also an important factor as well as the condition. Ventilators are usually used in patients that are in Intensive Care Unit (ICU) and after remaining in intubation after 48 hours the risk to the patient increases. Weaning from mechanical ventilation (MV) permits patients to restart spontaneous breathing steadily; however some risks are involved [12] and are mentioned in section. Risks and hazards to patients should always be considered when dealing with medical devices; however the benefits that they bring play a major role. But still as an advantage mechanical ventilators as mentioned before, bring vital support where initiation of breathing or respiration cannot be performed by the patient. Critical Comparison Figure Piston pump in HFOV Differences between each mechanical ventilator is defined by their operation mode which establish the flow pattern, pressure and volume delivered to the patient with the purpose of controlling alveolar ventilation and as a result achieve the goals of mechanical ventilation. Ventilation modes are determined by the combination of breathing pattern, type of ventilation and control. As for this MV operation mode is going to vary according to the age, and state of the patient, in a way that ventilation is provided and the risk is minimal. Requirements As mentioned before, the continuous use of ventilators may induce injury to the lungs. Air strained outside the normal air spaces creates a swelling pressure that may injure alveoli. The name of this condition is Barotrauma, and malfunction to the mechanical ventilation may occur. High pressures or volumes during inspiration, or when extreme PEEP is used are causes of Barotrauma. There has not been found an association of clinical injury with the level of pressure used, the problem is estimated to be an over expedition of volume [13]. High frequency ventilation(HFV) is a ventilation strategy for patients with respiratory failure; providing a small source of tidal volumes (VT) which is in most of the cases less than the anatomic dead space volume, with respiratory rates above 150rpm. Modern Research studies have shown that HFV can help reduce barotraumas in normal and injured lungs [14]. Figure Flow during high frequency ventilation HFV can be classified according to the source that generates their frequency and the type of exhalation phase; there are four types: High Frequency Jet Ventilation (HFJV), High Frequency Oscillatory Ventilation (HFOV), High Frequency Flow Interruption (HFFI), and High Frequency Positive Pressure Ventilation. The most commonly is used is the HFOV where in a continuous positive air pressure circuit the frequencies are oscillated by a piston pump (Fig. 10). During inspiration, each high frequency pulse in the flow creates a profile shaped like a bullet (Fig. 11), with the central molecules moving on beyond the airway than those found in the periphery. Table (2) describes and compares main differences between common ventilation and high frequency ventilation. Table Comparison between HF ventilator and Conventional ventilator HFV Conventional Ventilator Frequency is measured in Hertz (Hz) Frequency is measure in rpm Uses Displacement Volume (Vd) Uses Tidal Volume (Vt) Volume per minute is measured: Volume per minute is measured: Medical Devices Available on the Market There is a wide range of medical ventilators currently available on the market, and they all offer variety of options ranging in modes, variables monitored and ways of control [8] . Specific requirements and recommendations can be separated according to the complexity based on their performance. Some of the most common brands available nowadays are listed in table (3), and they all offer ventilators that may vary according to specific needs. Table Brands currently available Brand Model ACOMA ART-100 ART-21EX BIO-MED DEVICES CV-3 CV-4 DRAEGER Carina Home Evita 2 dura Evita 4 Evita XL Oxylog 1000 Oxylog 2000 Oxylog 3000 Savina EVENT MEDICAL Inspiration Inspiration LS GE HEALTHCARE(DATEX-OHMEDA) Centiva/5 Engstrom Carestation HAMILTON GALILEO GOLD RAPHAEL COLOR IMPACT Unit-Vent 754 INTERMED INTER5 PLUS/ GMX INTER PLUS VAPS/ GMX KIMURA KV-3N MAQUET Servo-i(Adult:Infant) Servo-S ( Adult: Pediatric) NEWPORT E100M E150 Breeze E360 E500 Wave PULMONETIC SYSTEMS/VYASIS HEALTHCARE LTV 900 LTVO 950 LTV 1000 RESPIRONICS Esprit SAIME ELISEE SIARE Siaretron 1000 ICU Siaretron 1000 IPER Siaretron 3000 ICU TAEMA eXtreria Horus 4 NEFTIS icu TECME Neumovent Graph TYCO HEALTHCARE PURITAN BENNETT 740 760 840 VERSAMED iVent201 VYASYS HEALTHCARE AVEA Vela Vela + Vela Comprehensive Future Stage of Development Advanced features like recording and accurate and advanced predictions will come in a future state of development. In addition the ability to link multiple devices on one is now available, where the ventilator monitor can display lectures from other devices. Portable devices are starting to become more common, they are light and compact devices. Important upgrades have been made to portable devices, where advanced features are now presented. Current portable ventilators present various modes of ventilation and longer power supply. In order to avoid complexity, it is important when developing new features to consider the principal use of ventilators, which is respiratory supply. In addition for longer term care many features may not be used and costs can increase. Conclusions Mechanical ventilators are vital equipments that provide vital support to a patient. They provide artificial respiration to patients that cannot breathe on their own. Their principle of operation is based on mechanical exchange of gases, and their circuitry includes electro-valves for their control and flowmeters as transducers. MV can become very complex devices, training of clinicians using them is crucial in order to avoid risks to patients. Hazards to patients may occur when used for more than 48 hours, however new techniques like high frequency ventilation can reduce this. There is a wide range of devices present on the market and they all vary on their modes of operation. Portable devices are now popular and present important features. Mechanical ventilators are used every day in hospitals and represent a critical part on vital support.

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Diego Rivera is considered the father of Mexican mural art and the father of modern political art in Mexico. Diego reinterpreted Mexican history from a revolutionary and nationalistic point of view. Not only did Diego expressed powerful ideas in his murals, but he also applied the tools he learned with modernist techniques. More than any other artist, Diego Rivera provided models for incorporating cultural past and ethnic identity into an alternative modernist vision, one that provided for a responsible fusion of the social and the aesthetic. Diego was an important personality in the art world of the 20th century and his thoughts were well respected in the art community. He was an innovator in expressing his ideals unifying art and politics. Diego Marà ­a de la Rivera y Barrientos and his twin brother Carlos were born on December 13, 1886 in Leon, Guanajuato. Carlos died in 1888, which left Diego as an only child. Since he was very young (he begins to draw at the age of three), he loved to paint, so much that his father covered a room of their house in Guanajuato with paper so that the child could paint all over the walls. Diego says that it was in that room where he created his first murals. In 1896, while he was still in high-school, he entered the Academy of San Carlos. He was so obviously talented that in 1906, after his first show, he was granted a four year scholarship from the governor of Veracruz, Teodoro Dahesa, to continue his studies in Europe. In 1907 he goes to Spain, where he promptly becomes part of the intellectual circles. After studying there for two years he moves to Paris and starts living with Angelina Beloff. Angelina Belloff was a Russian à ©migrà © artist. Diego met her in Spain among the artistic circles. Diego and Angelina had a son but due to an flu epidemic the child died in the fall of 1918. Diego had many lovers, among them was Marvena, another Russian woman. Diego and Marvena had a child named Marika right after the death of Angelina's baby. Diego precisely describes his relationship with Angelina when he says "She gave me everything a woman can give to a man. In return, she received from me all the heartache and misery that a man can inflict upon a woman" In June of 1921 Rivera left Belloff in Paris and goes to Mexico, saying that once he is established he will send for Angelina. He never doe... ... communist ideas through his paintings and in some way, this made him a symbol for communism. For this reason all his actions would be closely watched by the party. The communist party was very anti-government and Diego's commissions were mostly government-funded, which made him a doubtful communist. In September of 1926 he was expelled from the Mexican communist party for having accepted to be the director of the San Carlos Academy of Art. (He was granted this job by the government). Even though he tried many times, he was never accepted back into the party. Frida dies on July 13 of 1954. This marks the start of Diego's own death. In 1955 he is diagnosed with cancer but he keeps working on his murals. On July 29th, almost a year after Frida's death he marries Emma Hurtado, his agent since 1946. He is hospitalized in Russia and recovers completely from cancer. However, in September of the same year he suffers a blood clot and phlebitis, which paralyzes his right arm. He keeps working in some paintings and in decorating the house of his friend Dolores Olmedo. On November 24th of 1957 Diego Rivera dies of heart failure in his San Angel studio and wills his art to the Mexican Nation.

Art and Human Life

You could define art as vision or as intuition, as Benedetto Croce does in his essay â€Å"What is Art? † By this definition, the works of someone with a beautiful vision would be beautiful, and art would be an external manifestation of an internal state. The importance of art is related to the nature of our human built environment, and whether we create it to be a comfort or a torment. To understand the place of art and beauty in contemporary culture, you need to turn to history. You could define art as vision or as intuition, as Benedetto Croce does in his essay â€Å"What is Art? By this definition, the works of someone with a beautiful vision would be beautiful, and art would be an external manifestation of an internal state. The importance of art is related to the nature of our human built environment, and whether we create it to be a comfort or a torment. To understand the place of art and beauty in contemporary culture, you need to turn to history. Read more: Why Is Ar t Important in Life? | eHow. com http://www. ehow. com/about_6134201_art-important-life_. html#ixzz1MlGvu7yA Philosophy Art, like humor, can sometimes by deadened when dissected too thoroughly. Writers as accomplished and diverse as Leo Tolstoy in â€Å"What is Art† and Susan Sontag in â€Å"The New Art, A Critical Anthology† have pondered the meaning and function of art, yet it remains a nebulous term. Perhaps Picasso, in an interview with Marius de Zayas in 1923, best captured the elusive nature of art when he wrote that â€Å"art is a lie that makes us realize truth. † Challenges The great art historian Ananda Coomaraswamy, in his book, â€Å"The Transformation of Nature in Art,† wrote that â€Å"museums are the places were we've put the things that we've forgotten how to use. While museums have allowed millions to see the great works of art from throughout history, they also pose the threat of separating art from everyday life. William Morris believed that this separation was one of the causes of modern alienation, and that art should not be locked away in special buildings, but should be an integral part of society's daily life. When beauty and care are inherent in everything that is done, â€Å"art† in fact ceases to exist as a separate entity, and becomes an aspect of everything that we do. Future. The future of art remains uncertain. According to Morris, speaking of his admiration for medieval craftsmen who wed artistic vision with a mastery of handcraft, the reunion of the two could overcome the dichotomy between art and life, and lead to a culture re-infused with a sense of beauty, wonder, and singularity. A reunion of what we now know as â€Å"fine art† with the greater population of the world would, as Morris put it in his essay â€Å"The Revival of Handicraft,† lead to â€Å"the unwearying pleasure of tasting the fullness of life. † Read more: Why Is Art Important in Life? | eHow.com http://www.ehow.com/about_6134201_art-important-life_.html#ixzz1MlHaEcDs

Torts Cases and Digest

SERGIO F. NAGUIAT, doing business under the name and style SERGIO F. NAGUIAT ENT. , INC. , & CLARK FIELD TAXI, INC. , petitioners, NATIONAL LABOR RELATIONS COMMISSION (THIRD DIVISION), NATIONAL ORGANIZATION OF WORKINGMEN and its members, LEONARDO T. GALANG, et al. , respondents. FACTS: Naguiat is the president and a stockholder of Clark Field Taxi, Inc. (CFT). Due to the phase-out of the US bases in the country, Clark Air Base was closed and the taxi drivers of CFTI were separated from service.The drivers filed a complaint for the payment of sep. pay due to the termination/phase-out. NLRC held Naguiat and the company solidarily liable for the payment of sep. pay. ISSUE: WON Naguait should be held solidarily liable with CFTI. YES. HELD: Under the Corporation Code, Naguait is liable bec: (1) he actively managed the business; (2) there was evidence that CFTI obtained reasonably adequate insurance; and (3) there was a corporate tort in this case. Our jurisprudence is wanting to the defin ite scope of â€Å"corporate tort. Essentially, â€Å"tort† consists in the violation of a right given or the omission of a duty imposed by law. Simply stated, it is a breach of legal duty. PHILIPPINE NATIONAL BANK, petitioner, vs. THE COURT OF APPEALS, RITA GUECO TAPNIO, CECILIO GUECO and THE PHILIPPINE AMERICAN GENERAL INSURANCE COMPANY, INC. , respondents. Medina, Locsin, Coruna, & Sumbillo for petitioner. Manuel Lim & Associates for private respondents. Facts: Rita Gueco Tapnio had an export sugar quota of 1,000 piculs for the agricultural year 1956-1957.Since, she did not need it, she agreed to allow Mr. Jacobo Tuazon to use the said quotafor consideration of 2,500. Her sugar cannot be exported without sugar quota allotments. Sometimes, however a planter harvests less sugar than her quota so her excess quota is usedby her mother who pays for it. This is her arrangement with Mr. Tuazon. At the time of theagreement, she was indebted to PNB of San Fernando, Pampanga. Her i ndebtedness wasknown as a crop loan and was secured by her sugar crop, and since her quota was mortgagedto PNB, her arrangement with Mr.Tuazon had to be approved by the bank. Upon presentmentof the lease arrangement, the PNB branch manager revised it by increasing the lease amount to P2. 80 per picul for a total of P2,800. Such increase was agreed to by both Rita and Jacobo. However, when it was presented to the Board of Directors for approval, they further increasedthe amount to P3. 00 per picul. Jacobo asked for the reconsideration but he was denied thesame. The matter stood as it was until Jacobo informed Rita and PNB that he had lost interestin pursuing the deal.In the meantime, the debt of Rita with the PNB matured. Since she had asurety agreement with the Philippine American General Insurance Co. Inc. (Philamgen), thelatter paid her outstanding debt. Philamgen in turn demanded from Rita the amount whichthey paid the bank. Instead of paying the bank, Rita claimed that she told Philamgen that shedid not consider herself indebted to the bank since she had an agreement with Jacobo Tuazon. When such was discontinued, she failed to realized the income with which she couldhave paid her creditors.Philamgen filed a complaint for the collection of sum of moneyagainst Rita. Rita implicated PNB as a third party defendant claiming that her failure to paywas due to the fault or negligence of PNB. Issue: WON PNB is liable for the damage caused to Rita. Held: ?There is no question that Rita’s failure to utilize her sugar quota was due to thedisapproval of the lease by the Board of Directors of the petitioner, thus PNB should beheld liable. ? The Board justified the increase to P 3. 00 per picul by saying that it was the prevalent rateat that time.However, there was no proof that any other person was willing to lease thesugar quota allotment of Rita for a price higher than P2. 80 per picul. Just because thereare isolated transactions where the lease price was P3. 00 per picul does not mean thatthere are always ready takers. ?While PNB had the ultimate authority of approving or disapproving the proposed leasesince the quota was mortgaged to the bank, the latter certainly cannot escape itsresponsibility of observing precaution and vigilance which the circumstances of the case justly demanded in approving or disapproving the lease of said sugar quota. According to Art. 19 of the Civil Code, â€Å"[e]very person must in the exercise of his rightsand the performance of his duties, act with justice, give everyone his due and observehonesty and good faith. † This the petitioner failed to do. As a consequence, Art. 21 states,[a]ny person who willfully causes loss or injury to another in a manner that is contrary tomorals, good customs or public policy shall compensate the latter for the damage.On the liability of the corporation, the court ruled that, â€Å"[a] corporation is civilly liable inthe same manner as natural persons for torts, bec ause generally speaking, the rulesgoverning the liability of a principal or master for a tort committed by an agent or servantare the same whether the principal or master be a natural person or artificial person. All of the authorities agree that a principal or master is liable for every tort which he expresslydirects or authorizes, and this is just as true of a corporation as of a natural person.Acorporation, is liable therefore, whenever a tortuous act is committed by an officer oragent under express direction or authority from the stockholders or members acting as abody, or generally, from the directors as the governing body. NOTE: CLV tells us that it is clear from the ruling of the Court in this case that not everytortuous act committed by an officer can be ascribed to the corporation as its liability, for it isreasonable to presume that in the granting of authority by the corporation to its agent, such agrant did not include a direction to commit tortuous acts against third pa rties.Only when thecorporation has expressly directed the commission of such tortuous act, would the damagesresulting therefrom be ascribable to the corporation. And such a direction by the corporation,is manifested either by its board adopting a resolution to such effect, as in this case, orhaving taken advantage of such a tortuous act the corporation, through its board, expresslyor impliedly ratifies such an act or is estopped from impugning such an act. Our jurisprudence is wanting as to the definite scope of â€Å"corporate tort. Essentially,â€Å"tort† consists in the violation of a right given or the omission of a duty imposed by law; abreach of a legal duty. The failure of the corporate employer to comply with the law-imposedduty under the Labor Code to grant separation pay to employees in case of cessation of operations constitutes tort and its stockholder who was actively engaged in the managementor operation of the business should be held personally liable. Q: When is a corporation liable for tort?A: A corporation is liable for tort when: (a) the act is committed by an officer or agent (2) underexpress direction of authority from the stockholders or members acting as a body or through theBoard of Directors. Q: How can authority given to the agent of the corporation be determined? A: Either by: (a) such direction by the corporation is manifested, by its board adopting aresolution to such effect (b) by having takien advantage of such a tortious act, the corporationthrough its board, has expressly or impliedly ratified such an act or estopped from impugning thesame.Q: What is a derivative suit? A: Since, the act of the board is essentially that of the corporation and therefore corporate assetscannot escape enforcement of the award of damage to the tort victim. As a remedy, thestockholders may institute a derivative suit against the responsible board members and officersfor the damages suffered by the corporation as a result of the tort suit. M. H. WYLIE and CAPT. JAMES WILLIAMS, petitioners, vs. AURORA I. RARANG and THE HONORABLE INTERMEDIATE APPELLATE COURT, respondents. FACTSPetitioners Wylie and Williams were the assistant administrative officer and commandingofficer, respectively, of the US Naval base in Subic. Respondent Aurora Rarang was an employee inthe Office of the Provost Marshal assigned as the merchandise control guard. Wylie, as one of his duties, supervised the publication of the ? Plan of the Day? a daily publication thatfeatured among others, an ? action line inquiry?. On Feb. 3, 1978, an inquiry was published saying thatconfiscated goods were being consumed/ used for personal benefit by the merchandise controlinspector and that a certain ?Auring? was, in herself, a disgrace to the office. Rarang, being the onlyperson named Auring in the said office, went to press an action for damages against Wylie and Williamsand the US Naval Base. (That Rarang was indeed the Auring mentioned in the inquiry was provenby the apology letter issued by Wylie for the inadvertent publication. )She alleged that the article constituted false, injurious, and malicious defamation and libel tending toimpeach her honesty, virtue and reputation exposing her to public hatred, contempt and ridicule.Defendants alleged that (1) defendants acted in performance of their official functions as officersof the US Navy and are thus immune from suit (2) US Naval Base is immune from suit being aninstrumentality of the US Government and (3) the RTC has no jurisdiction over the subject matter andthe parties involved. Lower court ruling: defendants pay damages because acts were not official acts of the USgovernment, but personal and tortious acts (which are not included in the rule that a sovereign countrycan? t be sued without its consent). Suit against US Naval Base was dismissed.ISSUES1. WON officials of the US Naval Base inside Philippine Territory, in discharge of their official duties, areimmune from suit. 2. Are US offi cers who commit a crime or tortious act while discharging official functions still coveredby the principle of state immunity from suit? HELD1. Yes, they are immune. Ratio Officers of the US Navy as instrumentalities of the US government are immune from suit (but onlywhen they are acting/ discharging their official functions. Art. XVI, sec. 3 of 1987 constitution provides that state may not be sued without its consent.Buteven without this affirmation, court is still bound by the doctrine of incorporation. Thedoctrine is applicable not only to suits against the state but also to complaints filedagainst officials for acts allegedly performed by them in discharge of their official duties. The traditional rule of immunity excepts a State from being sued in the courts of another Statewithout its consent or waiver. This rule is a necessary consequence of the principles of independenceand equality of States. Because the activities of states have multiplied, it has been necessary todistingui sh them ? etween sovereign and governmental acts (jure imperii) and private, commercial and proprietary acts (jure gestionis). The result is that State immunity now extends only toacts jure imperii. There is no question, therefore, that the petitioners actively participated in screening thefeatures and articles in the POD as part of their official functions. Under the rule that U. S. officials in the performance of their official functions are immune fromsuit, then it should follow that the petitioners may not be held liable for the questioned publication.It is to be noted, however, that the petitioners were sued in their personal capacities for their allegedtortious acts in publishing a libelous article. 2. No. Ratio. Our laws and, we presume, those of the United States do not allow the commission of crimes in the name of official duty. The general rule is that public officials can be heldpersonally accountable for acts claimed to have been performed in connection with officialduti es where they have acted ultra vires or where there is showing of bad faith.Immunity from suitcannot institutionalize irresponsibility and non-accountability nor grant a privileged status notclaimed by any other official of the Republic. Under Art. 2176 of the civil code, whoever by act or omission, causes damage to another, therebeing fault or negligence is obliged to pay for the damage done. Such fault or negligence, if there is no pre-existing contractual relation between the parties, is called a quasi-delict and isgoverned by the provisions of this Chapter. Indeed the imputation of theft contained in the POD dated February 3, 1978 is adefamation against the character and reputation of the private respondent.Petitioner Wyliehimself admitted that the Office of the Provost Marshal explicitly recommended the deletion of thename Auring if the article were published. The petitioners, however, were negligentbecause under their direction they issued the publication without deleting the name â€Å"Auring. â€Å"Such act or omission is ultra vires and cannot be part of official duty. It was a tortious act whichridiculed the private respondent. The petitioners, alone, in their personal capacities are liable forthe damages they caused the private respondent GASHEM SHOOKAT BAKSH, petitioner, vs. HON.COURT OF APPEALS and MARILOU T. GONZALES, respondents. Public Attorney's Office for petitioner. Corleto R. Castro for private respondent. FACTS: Petitioner Gashem Shookat Baksh was an Iranian citizen, exchange student taking a medical course in Dagupan City, who courted private respondent Marilou Gonzales, and promised to marry her. On the condition that they would get married, she reciprocated his love. They then set the marriage after the end of the school semester. He visited Marilou’s parents to secure their approval of marriage. In August 1987, he forced her to live with him, which she did.However, his attitude toward her changed after a while; he would maltre at and even threatened to kill her, from which she sustained injuries. Upon confrontation with the barangay captain, he repudiated their marriage agreement, saying that he was already married to someone living in Bacolod. Marilou then filed for damages before the RTC. Baksh denied the accusations but asserted that he told her not to go to his place since he discovered her stealing his money and passport. The RTC ruled in favor of Gonzales. The CA affirmed the RTC decision. ISSUES:Whether or not breach of promise to marry is an actionable wrong. Whether or not Art. 21 of the Civil Code applies to this case. Whether or not pari delicto applies in t his case. HELD: The existing rule is that a breach of promise to marry per se is not an actionable wrong. This, notwithstanding, Art. 21 is designed to expand the concept of torts or quasi-delict in this jurisdictions by granting adequate legal remedy for the untold number of moral wrongs which is impossible for human foresight to specifica lly enumerate and punish in the statute books.Art. 21 defines quasi-delict: Whoever by act or omission causes damage to another, there being fault or negligence is obliged to pay for the damage done. Such fault or negligence, if there is no pre-existing contractual relation between the parties, is called quasi-delict and is governed by the (Civil Code). It is clear that petitioner harbors a condescending if not sarcastic regard for the private respondent on account of the latter’s ignoble birth, inferior educational background, poverty and, as perceived by him, dishonorable employment.From the beginning, obviously, he was not at all moved by good faith and an honest motive. Thus, his profession of love and promise to marry were empty words directly intended to fool, dupe, entice, beguile and deceive the poor woman into believing that indeed, he loved her and would want her to be his life partner. His was nothing but pure lust which he wanted satisfied by a Filipina who honest ly believed that by accepting his proffer of love and proposal of marriage, she would be able to enjoy a life of ease and security.Petitioner clearly violated the Filipino concept of morality and so brazenly defied the traditional respect Filipinos have for their women. It can even be said that the petitioner committed such deplorable acts in blatant disregard of Article 19 of the Civil Code which directs every person to act with justice, give everyone his due, and observe honesty and good faith in the exercise of his right and in the performance of his obligations. No foreigner must be allowed to make a mockery of our laws, customs and traditions. She is not in pari delicto with the petitioner.Pari delicto means in equal fault. At most, it could be conceded that she is merely in delicto. Equity often interfered for the relief of the less guilty of the parties, where his transgression has been brought about by the imposition of undue influence of the party on whom the burden of the original wrong principally rests, or where his consent to the transaction was itself procured by fraud. Phoenix Construction Inc. vs. IAC PHOENIX CONSTRUCTION INC V IAC (DIONISIO) 148 SCRA 353FELICIANO; March 10, 1987 NATURE PETITION for review of the decision of the IACFACTS – 130AM 15 November 1975 – Leonardo Dionisio, driving hisVolkswagen car, was on his way home to Makati from acocktails-and-dinner meeting with his boss where had taken â€Å"ashot or two† of liquor. Crossing the intersection of GeneralLacuna and General Santos Streets at Bangkal, Makati, not far from his home, when his car headlights (in his allegation)suddenly failed. He switched his headlights on â€Å"bright† andthereupon he saw a Ford dump truck looming some21/2meters away from his car. The dump truck, owned andregistered by Phoenix Construction Inc. as parked askew(partly blocking the way of oncoming traffic) on the right handside of General Lacuna Street facing the oncoming tra ffic. There were no lights nor any so-called â€Å"early warning† reflector devices set anywhere near the dump truck. The dump truckhad earlier that evening been driven home by Carbonel, itsregular driver. Dionisio claimed that he tried to avoid a collisionby swerving his car to the left but it was too late and his car smashed into the dump truck. As a result of the collision,Dionisio suffered some physical injuries including somepermanent facial scars, a â€Å"nervous breakdown† and loss of twogold bridge dentures. Dionisio commenced an action for damages claiming that thelegal and proximate cause of his injuries was the negligentmanner in which Carbonel had parked the dump truck. Phoenix and Carbonel countered that the proximate cause of Dionisio's injuries was his own recklessness in driving fast atthe time of the accident, while under the influence of liquor,without his headlights on and without a curfew pass. Phoenixalso sought to establish that it had exercised d ue care in theselection and supervision of the dump truck driver. CFI: in favor of Dionisio- IAC: affirmed TC but modified amounts ISSUE (obiter) WON last clear chance doctrine should be appliedtherefore exculpating Phoenix from paying any damages HELD NO- We hold that private respondent Dionisio's negligence was†only contributory,† that the â€Å"immediate and proximate cause†of the injury remained the truck driver's â€Å"lack of due care† andthat consequently respondent Dionisio may recover damages P a g e 6 though such damages are subject to mitigation by the courts(Article 2179, Civil Code of the Philippines). Ob iter Phoenix and Carbonel also ask us to apply what they refer toas the â€Å"last clear chance† doctrine. The theory here of petitioners is that while the petitioner truck driver wasnegligent, private respondent Dionisio had the â€Å"last clear chance† of avoiding the accident and hence his injuries, andthat Dionisio having fai led to take that â€Å"last clear chance† mustbear his own injuries alone. The last clear chance doctrine of the common law was imported into our jurisdiction by Picart vs. Smith but it is a matter for debate whether, or to what extent, ithas found its way into the Civil Code of the Philippines.Thehistorical function of that doctrine in the common law was tomitigate the harshness of another common law doctrine or rule-that of contributory negligence. The common law rule of contributory negligence prevented any recovery at all by aplaintiff who was also negligent, even if the plaintiff'snegligence was relatively minor as compared with the wrongfulact or omission of the defendant. The common law notion of last clear chance permitted courts to grant recovery to aplaintiff who had also been negligent provided that thedefendant had the last clear chance to avoid the casualty andfailed to do so.Accordingly, it is difficult to see what role, if any,the common law last clear chance d octrine has to play in a jurisdiction where the common law concept of contributorynegligence as an absolute bar to recovery by the plaintiff, hasitself been rejected, as it has been in A2179 CC- Is there perhaps a general concept of â€Å"last clear chance† thatmay be extracted from its common law matrix and utilized as ageneral rule in negligence cases in a civil law jurisdiction likeours?We do not believe so. Under A2179, the task of a court,in technical terms, is to determine whose negligence-theplaintiff's or the defendant's-was the legal or proximate causeof the injury. That task is not simply or even primarily anexercise in chronology or physics, as the petitioners seem toimply by the use of terms like â€Å"last† or â€Å"intervening† or â€Å"immediate. The relative location in the continuum of time of the plaintiff's and the defendant's negligent acts or omissions,is only one of the relevant factors that may be taken intoaccount. Of more fundamental im portance are the nature of thenegligent act or omission of each party and the character andgravity of the risks created by such act or omission for the restof the community.The petitioners urge that the truck driver (and therefore his employer) should be absolved fromresponsibility for his own prior negligence because theunfortunate plaintiff failed to act with that increased diligencewhich had become necessary to avoid the peril preciselycreated by the truck driver's own wrongful act or omission, Toaccept this proposition is to come too close to wiping out thefundamental principle of law that a man must respond for theforseeable consequences of his own negligent act or omission.Our law on quasi-delicts seeks to reduce the risks and burdensof living in society and to allocate them among the members of society. To accept the petitioners' proposition must tend toweaken the very bonds of society. Disposition CA decision is modified by reducing theaggregate amount of compensatory damage s, loss of expectedincome and moral damages Dionisio is entitled to by 20% of such amount REYNALDA GATCHALIAN, petitioner, vs. ARSENIO DELIM and the HON. COURT OF APPEALS, respondents. Pedro G. Peralta for petitioner. Florentino G. Libatique for private respondent.On July 11, 1973, petitioner Reynalda Gatchalian boarded as paying passenger a minibus owned by respondents. While the bus was running along the highway, a â€Å"snapping sound† was heard, and after a short while, the bus bumped a cement flower pot, turned turtle and fell into a ditch. The passengers were confined in the hospital, and their bills were paid by respondent’s spouse on July 14. Before Mrs. Delim left, she had the injured passengers sign an already prepared affidavit waiving their claims against respondents. Petitioner was among those who signed.Notwithstanding the said document, petitioner filed a claim to recover actual and moral damages for loss of employment opportunities, mental suffering and inferiority complex caused by the scar on her forehead. Respondents raised in defense force majeure and the waiver signed by petitioner. The trial court upheld the validity of the waiver and dismissed the complaint. The appellate court ruled that the waiver was invalid, but also that the petitioner is not entitled to damages. Issues: (1) Whether there was a valid waiver (2) Whether the respondent was negligent 3) Whether the petitioner is entitled to actual and moral damages Held: (1) We agree with the majority of the Court of Appeals who held that no valid waiver of her cause of action had been made by petitioner. A waiver, to be valid and effective, must in the first place be couched in clear and unequivocal terms which leave no doubt as to the intention of a person to give up a right or benefit which legally pertains to him. A waiver may not casually be attributed to a person when the terms thereof do not explicitly and clearly evidence an intent to abandon a right vested in suc h person.The circumstances under which the Joint Affidavit was signed by petitioner Gatchalian need to be considered. Petitioner testified that she was still reeling from the effects of the vehicular accident when the purported waiver in the form of the Joint Affidavit was presented to her for signing; that while reading the same, she experienced dizziness but that, seeing the other passengers who had also suffered injuries sign the document, she too signed without bothering to read the Joint Affidavit in its entirety.Considering these circumstances, there appears substantial doubt whether petitioner understood fully the import of the Joint Affidavit (prepared by or at the instance of private respondent) she signed and whether she actually intended thereby to waive any right of action against private respondent. Finally, because what is involved here is the liability of a common carrier for injuries sustained by passengers in respect of whose safety a common carrier must exercise ex traordinary diligence, we must construe any such purported waiver most strictly against the common carrier.To uphold a supposed waiver of any right to claim damages by an injured passenger, under circumstances like those exhibited in this case, would be to dilute and weaken the standard of extraordinary diligence exacted by the law from common carriers and hence to render that standard unenforceable. We believe such a purported waiver is offensive to public policy. (2) In case of death or injuries to passengers, a statutory presumption arises that the common carrier was at fault or had acted negligently â€Å"unless it proves that it [had] observed extraordinary diligence as prescribed in Articles 1733 and 1755. To overcome this presumption, the common carrier must show to the court that it had exercised extraordinary diligence to present the injuries. The standard of extraordinary diligence imposed upon common carriers is considerably more demanding than the standard of ordinary d iligence. A common carrier is bound to carry its passengers safely â€Å"as far as human care and foresight can provide, using the utmost diligence of a very cautious person, with due regard to all the circumstances†. The records before the Court are bereft of any evidence showing that respondent had exercised the extraordinary diligence required by law.The obvious continued failure of respondent to look after the roadworthiness and safety of the bus, coupled with the driver's refusal or neglect to stop the mini-bus after he had heard once again the â€Å"snapping sound† and the cry of alarm from one of the passengers, constituted wanton disregard of the physical safety of the passengers, and hence gross negligence on the part of respondent and his driver. (3) At the time of the accident, she was no longer employed in a public school. Her employment as a substitute teacher was occasional and episodic, contingent upon the availability of vacancies for substitute teacher s.She could not be said to have in fact lost any employment after and by reason of the accident. She may not be awarded damages on the basis of speculation or conjecture. Petitioner's claim for the cost of plastic surgery for removal of the scar on her forehead, is another matter. A person is entitled to the physical integrity of his or her body; if that integrity is violated or diminished, actual injury is suffered for which actual or compensatory damages are due and assessable. Petitioner Gatchalian is entitled to be placed as nearly as possible in the condition that she was before the mishap.A scar, especially one on the face of the woman, resulting from the infliction of injury upon her, is a violation of bodily integrity, giving raise to a legitimate claim for restoration to her conditio ante. Moral damages may be awarded where gross negligence on the part of the common carrier is shown. Considering the extent of pain and anxiety which petitioner must have suffered as a result of her physical injuries including the permanent scar on her forehead, we believe that the amount of P30,000. 00 would be a reasonable award. Petitioner's claim for P1,000. 00 as attorney's ees is in fact even more modest. JOSUE ARLEGUI, petitioner, vs. HON. COURT OF APPEALS and SPOUSES GIL AND BEATRIZ GENGUYON, respondents. Residential Apartment Unit no. 15 was leased for more than 20 years by Serafia Real Estate, Inc. tospouses Gil and Beatriz. In 1984, Alberto Barretto (one of the owners of Serafia) informed the tenants of the apartment bldg. that Serfia and its assets had already been assigned and transferred to A. B. Barretto. The tenants formed an organization called Barretto Apartment Tenant Association to represent them innegotiations with A. B.Barretto Enterprises for the purchase of the apartment units. Josue Arlegui waselected vice president and Mateo Tan Lu as auditor of the association. Genguyons were later surprised tolearn that the unit they were leasing had been sold to Mateo Tan Lu. Genguyons continued to occupy thepremises and paid rentals. They were then informed that Mateo Tan sold the apartment to Josue Arlegui. Arlegui demanded Genguyons to vacate the premises. ISSUE: Whether or not a constructive trust existed HELD: The petitioner denies that a constructive trust was created and maintains that there was no fraudcommitted.He neither received money from the Genguyons, nor was he unjustly enriched. However, therecords show that the Genguyons, along with the other tenants and members of the association,contributed money to enable the officers to negotiate with the Barrettos. Besides, constructive trusts donot only arise out of fraud or duress, but also by abuse of confidence, in order to satisfy the demands of justice. The petitioner also argues that the Genguyons’ failed to prove the existence of an implied or constructivetrust. We disagree.There is ample documentary and testimonial evidence to establish the existence of afiduciary r elationship between them, and that petitioner’s subsequent acts betrayed the trust andconfidence reposed on him. It is further argued that no implied trust, as defined under Article 1456 of the New Civil Code, was createdbecause the petitioner did not acquire the subject property through mistake or fraud. Nevertheless, theabsence of fraud or mistake on the part of the petitioner does not prevent the court from ruling that animplied or constructive trust was created nonethelessA constructive trust, otherwise known as a trust ex maleficio, a trust ex delicto, a trust de son tort, aninvoluntary trust, or an implied trust, is a trust by operation of law which arises contrary to intention and ininvitum, against one who, by fraud, actual or constructive, by duress or abuse of confidence, bycommission of wrong, or by any form of unconscionable conduct, artifice, concealment, or questionablemeans, or who in any way against equity and good conscience, either has obtained or holds the legalright to property which he ought not, in equity and good conscience, hold and enjoy.It is raised by equityto satisfy the demands of justice. However, a constructive trust does not arise on every moral wrong inacquiring or holding property or on every abuse of confidence in business or other affairs; ordinarily sucha trust arises and will be declared only on wrongful acquisitions or retentions of property of which equity,in accordance with its fundamental principles and the traditional exercise of its jurisdiction or inaccordance with statutory provision, takes cognizance.It has been broadly ruled that a breach of confidence, although in business or social relations, rendering an acquisition or retention of property byone person unconscionable against another, raises a constructive trust. *There was a breach of trust by the officers. SC annulled the sale of the apartment and ordered Arlegui toexecute deed of conveyance to Genguyon spouses BPI EXPRESS CARD CORPORATION, petitioner , vs. COURT OF APPEALS and RICARDO J. MARASIGAN, respondents. Marasigan was the holder of a BPI credit card. Due to his delinquency in payment, immediate demand was given by BPI to pay account.Marasigan issued a postdated check. The check was thereafter kept in custiody by BPI and card was temporarily suspended. And on a relevant date, Marasigan after eating in Cafe Adriatico tried to use his card to pay but it was dishonored. HELD: The issuance of the postdated check was not effective payment on the part of Marasigan and thus, the bank was justified in suspending temporarily his use of the credit card. A check is only a substitute for money and not money, and the delivery of such instrument doesn't itself operate as payment. BEATRIZ P. WASSMER, plaintiff-appellee, vs. FRANCISCO X.VELEZ, defendant-appellant. Jalandoni & Jamir for defendant-appellant. Samson S. Alcantara for plaintiff-appellee. FACTS: Respondent Francisco Velez and petitioner Beatriz Wassmer were lovers who set their marriage for Sept. 4, 1954. On Sept. 2, however, Francisco left for Cagayan de Oro, leaving Beatriz with a note that his mother was approved to the marriage. A day before the supposed wedding, on Sept. 3, Francisco telegrammed Beatriz that nothing changed and that he assured her of his return and love. Francisco did not appear after all nor words were heard from him again; despite the fact that preparations were all made.They applied for a marriage license on Aug. 23, and was issued thereof; invitations were printed and distributed to friends and relatives; dresses and other apparel were already bought; the two bought a matrimonial bed; bridal showers were given and gifts received. Beatriz then filed damages for breach of promise to marry. ISSUE: Whether or not breach of promise to marry is an actionable wrong. HELD: Mere breach of promise to marry is not an actionable wrong. But to formally set a wedding and go through all the preparations and publicity, and to walk out of it when the matrimony is about to be solemnized, is quite different.This is palpably and unjustifiably contrary to customs for which Francisco must be held answerable for damages in accordance with Art. 21 of the Civil Code. Under Art. 2232 of the Civil Code, the conditions precedent is that the defendant acted in a wanton, fraudulent, reckless, oppressive or malevolent manner. When a breach of promise to marry is actionable under Article 21, moral damages may be awarded under Art. 2219 (10) of the Civil Code. Exemplary damages may also be awarded under Art. 2232 of the Code where it is proven that the defendant clearly acted in wanton, reckless and oppressive manner.

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