How cultural beliefs and social forces are shaping the use of technology Essay

David Wigder, who has critical experience as an Environmental Engineer (2007) composed that advertisers have generally confronted a difficult task with regards to showcasing eco-accommodating products. Basically, it is hard to impact shopper buy conduct without first affecting mentalities and qualities. These qualities, notwithstanding, require a purposeful exertion over an extensive stretch of time to change. Subsequently, corporate advertisers will in general avoid mindfulness and instruction interchanges, liking to target buyers lower in the buy pipe who are now inclined to green informing. The explanation behind this is plainly obvious: with regards to green, obtaining efforts have higher and more prompt monetary returns than mindfulness crusades (Wigder, 2007). However, for advertisers, the open door exists to impact earth inviting conduct without fundamentally moving mentalities. This impact has been subject of scholarly examination including an investigation directed by Professors John Thogersen and Folke Olander of the Aarhus School of Business (Denmark) analyzing the connection between â€Å"value priorities† and â€Å"environmentally-accommodating customer conduct. † (Wigder, 2007) As a feature of this examination, Thogersen and Olander inspected the effect of reusing on the qualities and practices of Danish customers through the span of one year. (â€Å"Human Values and the Emergence of a Sustainable Consumption Pattern: A Panel Study,† Journal of Economic Psychology, 2002). The aftereffects of such examination uncover a few key discoveries that green advertisers ought to consider: †¢ First, the investigation reconfirmed that qualities drive conduct (while the opposite relationship was not seen as factually huge). While to be expected, this outcome affirms that advertisers face a difficult task on the off chance that they are to impact ecologically benevolent conduct without first tending to values. †¢ Second, the investigation found that qualities are truly steady and are hard to affect in the â€Å"short and medium term. † †¢ Finally, conduct change, the creators closed, is obstructed by values as well as by â€Å"behavioral idleness, made by powers [such as built up habits] that are free of †or if nothing else not related in a basic manner to †values†. (Dobson, 2007) However fundamentally for advertisers, the examination likewise proposes that for those that as of now hold earth amicable qualities, naturally agreeable conduct can advance after some time if purchasers are given the chance to take part in this conduct. Thogersen and Olander inferred that â€Å"when new open doors for naturally well disposed conduct are offered, customers holding ‘environmentally-accommodating values’ alter their conduct to be progressively reliable with their qualities. † This finding suggests that purchasers who hold green qualities will show greener conduct whenever gave important items or administrations (Wigder, 2007). Andrew Dobson wrote in an article called The Politics of Global Warming (2007), that in his survey of the thought and practice of economical utilization, Tim Jackson brings up that â€Å"the talk of ‘consumer sovereignty’ and ‘hands-off’ administration is mistaken and unhelpful† (see â€Å"Motivating Sustainable Consumption,† SDRN: Briefing 1). This is on the grounds that utilization choices occur inside a social and institutional setting which establish the guidelines of the game, and which part decide the customer choices that individuals make. So when the iPod little tags along hard behind the main barely bigger unique iPod, the social and monetary setting is outfitted to getting purchasers to get it (Dobson, 2007). In this unique situation, as Jackson went on, â€Å"policies dependent on data and value signals have had just constrained achievement in changing unreasonable behaviors†. However these are actually the arrangements the administration appears to be resolved to seek after †strategies that, additionally, add to imitating the ace individual setting that is part reason for our natural issues. â€Å"The prevailing social model in 21st-century society is individualist†, composed Tim Jackson. â€Å"But this is just one type of social association and there is proof to recommend that it may not be adequate to address the social unpredictability of ace natural conduct change. † But, approach creators will say, arrangements dependent on value signals work with the grain of personal circumstance and are subsequently reasonable as opposed to optimistic most definitely. Wrong. There is a developing group of sociology proof to propose that the personal circumstance model is really a poor indicator of ecological perspectives and conduct (Dobson, 2007). For example, in their overview of 4,000 people in four separate provinces in Sweden, Simon Matti and Christer Berglund infer that undoubtedly, â€Å"people are guided by different intentions and qualities than the customary financial levelheadedness of the purchaser †¦ they feel an ethical commitment to sort squander so as to add to a superior environment† (see â€Å"Citizen and buyer: the double job of people in ecological policy†, Environmental Policies, 15/4, 2006). Additional striking still, their examination unequivocally proposes that approaches intended to speak to the person as buyer instead of as resident â€Å"crowd out†, or decrease, â€Å"the feeling of good obligation† for master natural movement. By and by, the favored type of government strategy both fortifies the outlooks and direct that add to natural impracticality and at the same time subverts the propensities and practices that illuminate a lot of ace ecological conduct. This one-two punch is a genuine snag to managing environmental change †and without a doubt with whatever other issue which requires genius social reactions (Dobson, 2007). The way that these outcomes were accumulated in Sweden may itself be critical. This is on the grounds that a further bit of sociology investigate recommends that collectivist, social-government assistance social orders are a superior hatchery of expert ecological conduct than maverick ones where government assistance is looked on with doubt. â€Å"Those who place a high incentive on the government assistance of others and on an aggregate way to deal with tackling social issues are bound to be happy to help natural arrangements than the individuals who do not†, composes discovers Sharon Witherspoon (see â€Å"Democracy, the earth and popular supposition in Europe†, in W Lafferty and J Meadowcroft, eds. , Democracy and the Environment: issues and prospects (Edward Elgar, 1996). The entirety of this recommends tending to environmental change is both more troublesome and simpler than the official outlines twirling over the work areas of government priests and paper front-pages depict. It is progressively troublesome, in light of the fact that the drivers of impractical perspectives and conduct are more profound and more basic than supporters of liberal free enterprise can stand to accept. However it is likewise simpler, in light of the fact that protection from those drivers is communicated every day by the activities of a huge number of residents around the globe as they endeavor to make the best decision, not for any addition for themselves or dread of monetary discipline, but since it’s the proper activity (Dobson, 2007). Governments accept that individuals don’t carry on like that, and plan strategy in like manner. Sociology examine recommends two things: first, that individuals do carry on like this, and second, that administration arrangement which neglects to comprehend as much won't just be insufficient yet †in a move that changes over disaster into joke †will sabotage the very inspirations for the conduct which it ought to be empowering. Determination (A Vision for the Future) By the finish of the following decade, as deduced by David Friedman of the Union of Concerned Scientists, most traveler vehicles and trucks in the United States could be brimming with crossover electric vehicles. However, it is likewise evident that this all-new GREEN way of life that individuals are advancing relies a great deal upon social convictions or fundamentals (as appeared previously). Indeed, purchasing propensities are changing, open transportation may all become half breeds, the vehicle business may surrender gas motors everlastingly, and so on yet mixture innovation, way of life changes, and living â€Å"green† can't give the exact governmental issues that worldwide change needs. It’s sensible to declare that sound sociology is a piece of the entire riddle. R E F E R E N C E S 1. Mixture Cars. (2006). TechFaq. Recovered April 16, 2007, from http://www. tech faq. com/cross breed vehicles. shtml 2. Donaldson-Evans, C. (2006, July 10). Gas-electric half breeds simply continue onward and going. Recovered April 16, 2007 from http://www. foxnews. com/story/0,2933,202414,00. html 3. Wigder, D. (2007, March 31). What number of green advertisers does it take to change a light? Recovered April 16, 2007 from http://marketinggreen. wordpress. com/tag/customer practices and-convictions/4. Dobson, A. (2007, March 29). A legislative issues of a worldwide temperature alteration: the sociology asset. Recovered April 16, 2007 from http://www. opendemocracy. net/globalization-climate_change_debate/politics_4486. jsp 5. Friedman, D. (2003). A New Road: the Technology and Potential of Hybrid Vehicles. Massachusetts: UCS Publications. 6. Thogersen, J. what's more, Olander, Folke. (2002). Human Values and the Emergence of a Sustainable Consumption Pattern: A Panel Study. Diary of Economic Psychology, 23 (5), 605-630.

Seattle was gorgeous

Seattle was gorgeous Ive never been to Seattle before. One of the things I love about college is how many opportunities you get to live in a new place for a month or a few at a time. I specifically sought out a summer internship in Seattle because I wanted to try something new. Id heard from many people that Seattle is a gorgeous city. I was not disappointed. A lot of what people gush over when talking about the Pacific Northwest is the hiking. Drive any direction out of downtown Seattle, and in 3 hours or less youll find a gorgeous trail coiling through crests of evergreen trees and surrounded by the trilling of mountain streams. By far the best hike I went on this summer was the Summerland Trail at Mount Rainier, the crowning jewel of Seattles many mountains. The trail was absolutely magical. Me and my friends who went on the Summerland trail! The first part of the hike was pretty typical for Washington trails. You hike from the forest floor up into the foothills of the mountain, surrounded by towering trees and the constant babbling of mountain streams. But then, as we ascended, the trees gave way to small pockets of mountain-ringed meadows, filled with grass and flowers. And eventually, when you climb high enough, the surrounding slopes fell away, leaving a point-blank perspective of Mount Rainier. The larger meadow at the top of the mountain felt like something out of a Disney movie. I could barely believe it was real. There was one little point where you could stand with a clear babbling brook on each side in an emerald meadow spotted with summertime flowers and the rocky, snow-capped summit of Rainier in the background. The summit of Mount Rainier If you keep climbing, it starts to feel like youre on a different planet. The grass goes away, leaving the chewed-up rock of the mountaingray, rusty read, even turquoise in places. At one point we had to hop between stones to cross a river. We found a turquoise lake framed against a towering cliff face. A small turquoise lake surrounded by rocky peaks To get to the top of the cliff, you have to hike over snow and slippery shale [RIGHT WORD?] that could shift at any moment. But the view over the mountain range is incredible. The diversity and beauty of the scenery was mind-blowing. I did three other trails while in Seattle. Lake 22. Presumably there are another 21 lakes in the area. Unfortunately we only saw this one, but fortunately it was gorgeous. I forget the name of this lake, but doesnt it look like Hogwarts should be hanging around somewhere? This was taken in the Olympics, a big mountain range southwest of Seattle. Believe me, we had to work for this view! And we also went Rainier cherry picking. The cherries were so pretty I almost didnt want to eat them. But as much as Seattle is known for its hiking, I, being a native of LA, I am inevitably enchanted by water. Seattle is built around water. It was the constant sparkle of the sun over the lakes that took my breath away. Lake Washington One of my favorite things to do after work was to walk down to Lake Washington10 minutes away from my work and 5 minutes from my houseand watch the sun set. Having the lake in such close proximity was magicaluntil halfway through August. Thats when the smoke came in. The sun hasnt set. You just cant see it behind all the clouds. This was from my last weekend in Seattle, on the ferry to San Juan island. I cant express how tragic the smoke was without first showing you how gorgeous the city is. The last two weeks I was in Seattle, the whole city was covered by a pungent brown haze. The air quality made it hard to breathe outside. The reduced visibility marred the view of the lake. The weekend I went to San Juan, a quaint island north of Seattle and across the water from Canada, the smoke was so bad up near the Canadian forest fires that it honestly almost wasnt worth being outside. A friend and I went kayaking (normally one of my favorite activities) but the whole sky was brown and I had a headache for most of the time. Especially since Im from SoCal, which has been dealing with its own increasingly ravaging fires lately, the two weeks of smoke was really disturbing. It was the first time Ive felt like Ive actually experienced the effects of environmental destruction. Up until halfway through August, I could picture myself living in the city, in spite of the long rainy winter, as long as I got the summers. Now Im not sure.

Shakespeares Fair Youth Sonnets

The first of Shakespeares 126 sonnets are addressed to a young man – described as the â€Å"fair youth† – and reveal a deep, loving friendship. The speaker encourages the friend to procreate so that his youthful beauty can be carried on through his children. The speaker also believes that the man’s beauty can be preserved in his poetry, as the final couplet of Sonnet 17 reveals: But were some child of yours alive that time, [in the future]You should live twice: in it, and in my rhyme. Some believe that the intimacy of the relationship between the speaker and the young man is evidence of Shakespeare’s homosexuality. However, this is probably a very modern reading of a classical text. There was no public reaction to the relationship when the sonnets were first published by Thomas Thorpe in 1609, suggesting that the expression of a deep friendship through such language was perfectly acceptable in Shakespeares time. It was perhaps more shocking to the Victorian sensibility. Top Five Most Popular Fair Youth Sonnets: Sonnet 1: From Fairest Creatures We Desire Increase Sonnet 18: Shall I Compare Thee To A Summers Day? Sonnet 29: When In Disgrace With Fortune and Mens EyesSonnet 73: That Time Of Year Thou Mayst In Me Behold Sonnet 116: Let Me Not To The Marriage Of True Minds A full list of the Fair Youth Sonnets (Sonnets 1 – 126) is also available.

Discuss the Relationship Between Stress, Anxiety, Habits...

â€Å"Discuss the relationship between stress, anxiety, habits and describe how you would treat these issues with hypnotherapy†. Introduction Common requests for hypnotherapy treatment are those related to stress, anxiety, habits and phobias. An understanding of the relationship between these disorders, examining the similarities and the differences between each, provides the therapist with information useful in deciding how and if to treat these disorders. It could also be argued that the uniqueness of each client and each set of symptoms demands the therapist to review each case on a one to one basis and not to blur the boundaries between each of these types of disorders, which may in turn result in a less effective form of treatment†¦show more content†¦They go on to say that these needs are determined by pinpointing the individuals stress stimuli and their accompanying responses. Successful hypnotherapy treatment will include asking the client to examine the exact stimuli that contribute to their stress and their physical and emotional responses to each stimulus. This will then be followed by using suggestions within hypnotherapy to embed new responses to each of these stress stimulus. Understanding Anxiety One of the negative effects induced by stress is anxiety. Whereas stress is caused by an existing stress-causing factor or stressor, anxiety is stress that continues after that stressor is gone. Anxiety is a feeling of apprehension, where often the source of this uneasiness is not always known or recognized, which can add to the distress felt by the client. According to Hadley and Staudacher, anxiety does not arise directly out of painful or dangerous situations. Instead, it’s the thought of potential danger, not the actual danger, which produces the symptoms of anxiety. This is similar to the work done by Lazarus and Folkmans on their interpretation of stress. This process is referred to as the ABC model of anxiety, the situation – A, gives rise to the thought – B, which in turn causes the anxiety – C. Anxiety is sometimes considered to be a normal reaction to stress. It may help a person to deal with a difficult situation, howeverShow MoreRelated‚Äà ºDiscuss the relationship between stress, anxiety, habits and phobias and describe how you would treat these issues with hypnotherapy‚Äà ¹.4857 Words   |  20 PagesTitle: â€Å"Discuss the relationship between stress, anxiety, habits and phobias and describe how you would treat these issues with hypnotherapy†. Module Five: Hypnotherapy and Counselling Skills Date: 27th April 2013 2000 words INTRODUCTION This essay will briefly research evidence on the four conditions and demonstrate the impact that stress has on our everyday lives whilst showing how it is linked to the other conditions of anxiety, phobiasRead MoreRelationship Between Stress, Anxiety and Phobias1999 Words   |  8 Pages Discuss the relationship between stress, anxiety, habits and phobias and describe how you would treat these issues with hypnotherapy In order to understand the relationship between stress, anxiety, habits and phobias, it is necessary to first define what each one is and how it might affect individuals. Stress could be defined as a normal physiological response by the body to situations or stimuli which the brain perceives as dangerous or threatening to the body. The body is a complex system

David Luke Rocco An Innocent Man - 938 Words

David Luke Rocco is not an innocent man; his guilt has been proven beyond a reasonable doubt from the evidence presented at his prior trial. If it is known that law enforcement was, in fact, correct in searching this evidence, why should they be penalized for continuing with these searches? The plaintiff was stopped and arrested under the terms of a legitimate and current offense. What reasons do we have to deny law enforcement a search for further contraband/or crimes? Not only was the cell phone in the plaintiff’s possession at the time of the crime, but it was also unlocked allowing anyone access to the phone. The law enforcement, at the time, had reason to believe that immediate danger could come to them through this cell phone (what if he had texted a detonation or an attack). Should we excuse the evidence merely because it was found as general offenses rather than the specific intended offenses? Statement of the Facts David Luke Rocco was a gang member who committed multiple crimes, including shooting at an occupied vehicle, attempted murder, and assault with a semi-automatic weapon. After being stopped for driving with expired license plates, his cellphone was seized and searched by the police which helped identify and convict him of these crimes. Evidence found included a photo of the plaintiff standing in front of the car he was convicted of shooting and standing near other men who were accused as accomplices to this crime, videos of the plaintiffShow MoreRelatedStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 Pages(Prentice Hall, 2012) Management, 11th ed. with Mary Coulter (Prentice Hall, 2012) Fundamentals of Human Resource Management, 10th ed., with David DeCenzo (Wiley, 2010) Prentice Hall’s Self-Assessment Library 3.4 (Prentice Hall, 2010) Fundamentals of Management, 8th ed. , with David DeCenzo and Mary Coulter (Prentice Hall, 2013) Supervision Today! 7th ed., with David DeCenzo and Robert Wolter (Prentice Hall, 2013) Training in Interpersonal Skills: TIPS for Managing People at Work, 6th ed., with Phillip

Review Of Escape From New York Essay Example For Students

Review Of Escape From New York Essay In the opening sequence of John Carpenters Escape From New York, an anonymous narrator sets the tone of desperation and hopelessness with the line once you go in, you never come out. The narrator is referring to the only rule in the maximum security prison built on Manhattan Island. The prison, which was built in 1981 as a reaction to the crime rate going up 400 percent, has no guards. Its every man for himself. The once busy streets of New York city are now nearly deserted, decayed, and run by criminals. The hell on Earth is so unbearable that some attempt to break out of the prison, on a raft, in an almost EscapeFrom Alcatraz fashion in the opening scene. The plot thickens as a group of terrorists hijack the Presidents plane and crash it in New York. The President is now somewhere in the New York prison and holds an importanttape containing a speech that could prevent another world war. Snake Plissken, a tough, renowned war hero and recent inmate of the prison, is the governments o nly hope to save the world. Snake must capture the Presidentwithin 24 hours so the President can present the tape at a peace summit the next day. In exchange for his good deed, the government promises to pardon him for every crime he has ever committed. The only catch is the two capsules implanted in his head. If he doesnt complete the mission in 24 hours the capsules will explode. Along the journey, Snake meets a rainbow of characters. He runs into Cabbie, who has driven the same taxifor 30 years in New York. He represents the nostalgia of the once great Big Apple. Snake fights the evil Duke ofNew York to capture the President. The Duke is the typical bad guy clad in lavish gold chains and surrounded by agroup of dimwitted followers. Snake befriends Brain, a timid reserved genius and Maggie, his beautiful girlfriend. Their love affair adds a humanistic touch to the cold insensitive surroundings. In the midstof escaping from the prison, Brain dies on a bridge. Maggie refuses to go on with Snake and calmly awaits her own impending death on the bridge. Dismal tragedy doesnt dominate the movie, however. Elements of humor are found in scenes such as the prisoners song and dance rendition of the Broadway tune Everybodys Coming to New York and the recurring line mentioned to Snake by each person he meets: I thought you were dead. In addition to humor, several strong themes are found in the film. Escape From New York can be easily compared to a mythic epic journey despite Snakes anti-hero I dont give a damn qualities. The gods (the government) sends Snake on a journey to capture the President. Difficult obstacles hinder his quest. At one point, he must fight a giant with clubs (baseball bats with spikes attached) and a shield (a trashcan lid). EscapeFrom New York can also be compared to a Western with a futuristic twist. The good guys (Snake) and the bad guys (the Duke and his gang) are clearly defined. Old fashioned pistols are replaced with explosives and machineguns. The most obvious theme, however, is its attempt to address todays social problems. If the crime rateactually rose dramatically, what would America do about it? Would they take such drastic measures and put allthe misfits of society on an island to die to avoid the risk of repeat offenders? The issue of Americas diminishing trust in fair honest government and its leaders is also raised. When Snake is told that the Presidentis missing he nonchalantly says, So? Get a new one. This movie attempts to enlighten the viewer about these issues in addition to entertaining them. .u946f27d32c70bb0a98f769180ace5ce9 , .u946f27d32c70bb0a98f769180ace5ce9 .postImageUrl , .u946f27d32c70bb0a98f769180ace5ce9 .centered-text-area { min-height: 80px; position: relative; } .u946f27d32c70bb0a98f769180ace5ce9 , .u946f27d32c70bb0a98f769180ace5ce9:hover , .u946f27d32c70bb0a98f769180ace5ce9:visited , .u946f27d32c70bb0a98f769180ace5ce9:active { border:0!important; } .u946f27d32c70bb0a98f769180ace5ce9 .clearfix:after { content: ""; display: table; clear: both; } .u946f27d32c70bb0a98f769180ace5ce9 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u946f27d32c70bb0a98f769180ace5ce9:active , .u946f27d32c70bb0a98f769180ace5ce9:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u946f27d32c70bb0a98f769180ace5ce9 .centered-text-area { width: 100%; position: relative ; } .u946f27d32c70bb0a98f769180ace5ce9 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u946f27d32c70bb0a98f769180ace5ce9 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u946f27d32c70bb0a98f769180ace5ce9 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u946f27d32c70bb0a98f769180ace5ce9:hover .ctaButton { background-color: #34495E!important; } .u946f27d32c70bb0a98f769180ace5ce9 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u946f27d32c70bb0a98f769180ace5ce9 .u946f27d32c70bb0a98f769180ace5ce9-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u946f27d32c70bb0a98f769180ace5ce9:after { content: ""; display: block; clear: both; } READ: Parenting Styles EssayMany critics have complained that this movie leaves too many questions unanswered, but I find Carpentersuse your imagination approach to the movie refreshing. In the final scene, Snake asks the President how he feels about the lives lost in the attempt to rescue him (the President). The President, who is about to go the air,impatiently responds this country appreciates their sacrifice. Snake walks away dissatisfied with the Presidents halfhearted answer as the President plays the tape containing the important

MEKANISME HEMOSTASIS Essays - , Term Papers

MEKANISME HEMOSTASIS Urutan mekanisme hemostasis dan koagulasi dapat dijelaskan sebagai berikut: 1. Segera setelah pembuluh darah terpotong atau pecah, rangsangan dari pembuluh darah yang rusak itu menyebabkan dinding pembuluh berkontraksi sehingga dengan segera aliran darah dari pembuluh darah yang pecah akan berkurang (terjadi vasokontriksi). 2. Setelah itu, akan diikuti oleh adhesi trombosit, yaitu penempelan trombosit pada kolagen. ADP (adenosin difosfat) kemudian dilepaskan oleh trombosit kemudian ditambah dengan tromboksan A2 menyebabkan terjadinya agregasi (penempelan trombosit satu sama lain). Proses aktivasi trombosit ini terus terjadi sampai terbentuk sumbat trombosit, disebut juga hemostasis primer. 3. Setelah itu dimulailah kaskade koagulasi (lihat gambar.1) yaitu hemostasis sekunder, diakhiri dengan pembentukan fibrin. Produksi fibrin dimulai dengan perubahan faktor X menjadi faktor Xa. Faktor X diaktifkan melalui dua jalur, yaitu jalur ekstrinsik dan jalur intrinsik. Jalur ekstrinsik dipicu oleh tissue factor/tromboplastin. Kompleks lipoprotein tromboplastin selanjutnya bergabung dengan faktor VII bersamaan dengan hadirnya ion kalsium yang nantinya akan mengaktifkan faktor X. Jalur intrinsik diawali oleh keluarnya plasma atau kolagen melalui pembuluh darah yang rusak dan mengenai kulit. Paparan kolagen yang rusak akan mengubah faktor XII menjadi faktor XII yang teraktivasi. Selanjutnya faktor XIIa akan bekerja secara enzimatik dan mengaktifkan faktor XI. Faktor XIa akan mengubah faktor IX menjadi faktor IXa. 4. faktor IXa akan bekerja sama dengan lipoprotein trombosit, faktor VIII, serta ion kalsium untuk mengaktifkan faktor X menjadi faktor Xa. 5. faktor Xa yang dihasilkan dua jalur berbeda itu akan memasuki jalur bersama. Faktor Xa akan berikatan dengan fosfolipid trombosit, ion kalsium, dan juga faktor V sehingga membentuk aktivator protrombin. 6. Selanjutnya senyawa itu akan mengubah protrombin menjadi trombin. Trombin selanjutnya akan mengubah fibrinogen menjadi fibrin (longgar), dan akhirnya dengan bantuan fakor VIIa dan ion kalsium, fibrin tersebut menjadi kuat. Fibrin inilah yang akan menjerat sumbat trombosit sehingga menjadi kuat. 7. Selanjutnya apabila sudah tidak dibutuhkan lagi, bekuan darah akan dilisiskan melalui proses fibrinolitik. Proses ini dimulai dengan adanya proaktivator plasminogen yang kemudian dikatalis menjadi aktivator plasminogen dengan adanya enzim streptokinase, kinase jaringan, serta faktor XIIa. Selanjutnya plasminogen akan diubah menjadi plasmin dengan bantuan enzim seperti urokinase. Plasmin inilah yang akan mendegradasi fibrinogen/fibrin menjadi fibrin degradation product [pic] Gangguan hemostasis (perdarahan abnormal) dapat disebabkan oleh beberapa hal di bawah ini: 1. Kelainan vaskuler Kelainan vaskuler adalah sekelompok kelompok keadaan heterogen, yang ditandaiu oleh mudah memar dan perdarahan spontan dari poembuluh darah kecil. Kelainan yang mendasari terletak pada pembuluh darah itu sendiri atau dalam jaringan ikat perivaskular. Pada keadaan dseperti ini, uji penyaring standart member hasil normal. Masa perdarahan normal, uji hemostasis lain juga normal. Kelainan vaskular ini terdapat dua jenis yakni herediter yang berupa Telangiektasia hemoragik herediter, serta kelainan jaringan ikat. Jenis yang lain adalah Defek vaskular didapat . 2. Trombositopenia Trombositopenia didefinisikan sebagai jumlah trombosit kurang dari 100.000/mm3. Biasanya ditandai dengan purpura kulit spontan, perdarahan mukosa, dan perdarahan berkepanjangan setelah trauma. Beberapa penyebab trombositopenia antara lain: (1)Kegagalan produksi trombosit .Ini merupakan penyebab tersering trombositopenia yang biasanya juga merupakan bagian dari kegagalan sumsum tulang generalisata Penekanan megakarisit selektif dapat disebabkan oleh toksisitas obat atau infeksi virus. (2)Peningkatan destruksi trombosit, Hal ini dibagi menjadi beberapa jenis yakni: a.Trombositopenia imun,termasuk di dalamnya ITP, karena infeksi, purpura pascatranfusi, Trombositopenia imun karena diinduksi obat, b.Purpura trombositopenia trombotik c.Koagulasi intravaskular diseminata, (3)Distribusi trombosit abnormal, (4)Kehilangan akibat dilusi, yakni berupa transfuse masif darah simpan pada pasien dengan perdarahan. 3. Gangguan koagulasi Bisa karena herediter maupun didapat, yang umumnya menggangu faktor-faktor koagulasi. a.Herediter : hemofilia A dan hemofilia B b.Didapat : defisiensi vitamin K dan penyakit hati 4.Gangguan fungsi trombosit Dibagi menjadi dua jenis, yakni: a.Didapat 1) karena obat anti trombosit seperti aspirin, 2).hiperglobulinemia, 3).kelainan mieloproliferatif dan mielodisplastik , serta 4)Uremia. b.Kelainan herediter 1) Trombastenia, 2)Sinsrom Bernard soulier, 3) Penyakit penyimpanan KELAINAN KOAGULASI . Hemofili A . Hemofili B . Kekurangan vit K (II,VII, IX, XI) Ganggan fungsi hati . DIC Adanya tissue factor (endotoxin, kerusakan jaringan dll) TF aktivasi koagulasi diikuti aktifasi fibrinolitik bergantian. Trombositopeni, APTT, PPT, TT memanjang, fibrinogen turun, FDP squestrasi PEMERIKSAAN LAB HEMOFILIA . Clotting time memanjang . APTT memanjang . Kadar Faktor VII menurun pada hemophilia A dan faktor IX menurun pada hemophilia B DIAGNOSIS DARI HASIL LAB PADA HEMOFILIA . Clotting time memanjang, Bleeding time normal . APTT memanjang, PPT normal