Wednesday 16 June 2010

How to Make an Essay Flow

  • Read over your essay and write the main objective of the essay at the top of the page on a sheet of paper.
  • Read each paragraph carefully and summarize the main topic of each in a simple word or phrase. List these topics on the sheet of paper.
  • Put the first sheet of paper aside and explain what you are trying to convey through your essay out loud or in your head without looking at the essay or the list of topics. As you explain your point naturally and in your own words, jot down each topic you cover as you are going through your explanation on a separate sheet of paper.

  • Compare the topic list from step 2 with the topic list from step 3, and change the order of your paragraphs to match the way that you would naturally explain your objective.

  • Read through your essay from the beginning, with the paragraphs rearranged in the most natural order, pausing at the beginning of each new paragraph.

  • Look at both the topic you have just finished discussing and the topic that is about to be discussed, and add a simple, clear transitional sentence at the beginning of each new paragraph to tie it into the previous paragraph. For example, say you are writing a paper about the success of "I Love Lucy," and have just ended a paragraph about how the advanced filming techniques used on the show have contributed to its ongoing success. If the next paragraph will discuss the popularity of the show at the time, then a reasonable transitional sentence might be: "While the success of the innovations that came out of "I Love Lucy" deserve a great deal of respect, the popularity of the show itself must not be overlooked."

  • After placing transitional sentences at the beginning of each paragraph, read the essay from the beginning. If there is any place where the essay does not sound like a well informed explanation of the objective to a friend, add transitional sentences in the weak spots. Your essay should now have a cohesive, natural flow.

  • Step 2

    Read each paragraph carefully and summarize the main topic of each in a simple word or phrase. List these topics on the sheet of paper.

  • Step 3

    Put the first sheet of paper aside and explain what you are trying to convey through your essay out loud or in your head without looking at the essay or the list of topics. As you explain your point naturally and in your own words, jot down each topic you cover as you are going through your explanation on a separate sheet of paper.

  • Step 4

    Compare the topic list from step 2 with the topic list from step 3, and change the order of your paragraphs to match the way that you would naturally explain your objective.

  • Step 5

    Read through your essay from the beginning, with the paragraphs rearranged in the most natural order, pausing at the beginning of each new paragraph.

  • Step 6

    Look at both the topic you have just finished discussing and the topic that is about to be discussed, and add a simple, clear transitional sentence at the beginning of each new paragraph to tie it into the previous paragraph. For example, say you are writing a paper about the success of "I Love Lucy," and have just ended a paragraph about how the advanced filming techniques used on the show have contributed to its ongoing success. If the next paragraph will discuss the popularity of the show at the time, then a reasonable transitional sentence might be: "While the success of the innovations that came out of "I Love Lucy" deserve a great deal of respect, the popularity of the show itself must not be overlooked."

  • Step 7

    After placing transitional sentences at the beginning of each paragraph, read the essay from the beginning. If there is any place where the essay does not sound like a well informed explanation of the objective to a friend, add transitional sentences in the weak spots. Your essay should now have a cohesive, natural flow.

  • Tuesday 1 June 2010

    Penurunan Kesadaran

    Kesadaran merupakan ketanggapan pada diri sendiri dan lingkungan sekitarnya. Dimana pada penurunan tingkat kesadaran, terdapat gangguan arousal maupun fungsi mental.

    Tingkat kesadaran yang utuh diatur oleh kedua hemisfere serebri dan ARAS (ascending reticulating activation system)


    Pendekatan klinis pada pasien dengan gangguan kesadaran :
    • Selalu lakukan ABCs (Airway, Breathing, Circulation)
    • Pencarian etiologi (dari anamnesa singkat dan tanda rangsang meningeal)
    • Lakukan pemberian glukosa, thiamin, dan naloxone bila diperlukan. Kebanyakan keadaan gawat dengan tidak ada etiologi membutuhkan ini.
    • Lakukan pemeriksaan neurologik untuk menentukan ada tidaknya refleks batang otak dan mencari tanda fokal
    • Jika ada tanda fokal : kerusakan struktural
    • Jika tidak ada tanda fokal : kerusakan diffuse



    Jika dicurigai adanya lesi struktural, lakukan noncontrast head CT.
    Jika dicurigai adanya lesi diffuse, CT scan kepala digunakan untuk melihat adanya edem serebral, tanda dari kerusakan iskemik hipoksik global, lesi bilateral yang menyerupai proses diffuse.
    CT scan harus didahului sebelum dilakukan LP. Untuk mencegah herniasi otak jika terdapat massa intracranial.
    EEG dilakukan untuk melihat seberapa dalam coma dan dapat mencari diagnosisnya.

    Pengobatan pada pasien dengan penurunan kesadaran dilakukan dengan koreksi etiologi.
    Jika terdapat peningkatan tekanan intrakranial, segera lakukan reposisi kepala (naikkan 30 derajad, hiperventilasi, dan berikan diuretik osmotik mannitol).
    Jika tekanan intrakranial rendah tetapi masih terdapat kegawatan neurologik, curiga adanya herniasi otak .
    Prognosis tergantung dari etiologi dan umur pasien

    Fungsi Kortikal Luhur

    Definisi : pengetahuan yang mengkaitkan perilaku manusia (behavior) dengan susunan saraf di otak. Gangguan ini dikaitkan dengan keadaan subsistem neuroanatomi.

    Otak secara umum dibagi m
    enjadi 2 bagian; kanan dan kiri.
    dimana otak kiri (hemisfere kiri) banyak mengatur kemampuan berbahasa, dan otak kanan (hemisfere kanan) mengatur visuospatial, emosi dan atensi.

    Gangguan berbahasa (afasia)
    • biasa terjadi karena kerusakan di hemisfere kiri
    • pemeriksaan yang biasa dilakukan adalah : berbicara spontan, penamaan, pengulangan, pemahaman, membaca, menulis.
    • afasia broca (non-fluent) : percakapan tidak lancar, kalimat yang diucapkan pendek, gangguan artikulasi, tetapi pemahaman normal. Prognosa baik
    • afasia wernicke (fluent) : percakapan lancar tetapi tanpa makna, artikulasi baik, pemahaman buruk, kelainan terjadi di hemisfere kiri bagian posterior, dan mirip psikotik. Prognosis kurang.
    • afasia global : kelainan terletak di anterior dan posterior, seringkali mengenai arteri karotis interna, disertai hemiplegia dextra. Prognosis buruk.

    Ingatan (Memory)
    • Immediate memory : beberapa detik
    • recent memory (new learn ability) : beberapa menit-jam-hari.
    • remote memory : bertahun-tahun lalu. Berkaitan dengan masalah pribadi masa lalu