Quality of life for Women with bleeding disorders Essay

Quality of life for Women with bleeding disorders - Essay Example However, health care physicians play a significant role in detecting signs and symptoms of vWD and in the ensuring that proper management is given to patients suffering from the disease (Lillicrap and James 2009). Von Willebrand Disease (VWD) is named after Dr. Erik von Willebrand (1870-1949) who first described the condition in 1926. He became famous for his description of bleeding among inhabitants of the island of Foglo in the Aaland archipelago in the Baltic Sea. In 1925, he examined a 5-year old patient whose four siblings died of bleeding disorders. In his report, he presented this as an unidentified type of hemophilia. He initially called the disorder â€Å"pseudohemophilia† because of lengthened bleeding time. During the course of his study, he noted that platelets were involved so he renamed it â€Å"constitutional thrombopathy† (Owens 2007). The ability of blood to clot is usually affected by vWD and can cause excessive bleeding. In rare cases, such bleeding m ay harm the internal organs or may even be fatal. VWD manifests in a deficiency in protein in the blood which is called von Willebrand factor (vWF) found in the linings of the blood vessels. Bleeding occurs when blood vessels are injured. Blood cells called platelets cluster together to block the hole in the blood vessel and control the bleeding. vWF serves as adhesion to help the platelets bond together to form a blood clot. Another vital protein that helps the blood clot is factor VIII (FVIII) found in vWF. FVIII is normally inactive in hemophilia which is another clotting disorder. In comparison with hemophilia, vWD more common and less serious among inherited bleeding disorders. It affects 1 out of 100 to 1000 people. Unlike hemophilia which mostly affects males, vWD has effects in both males and females (NHLBI 2008). vWD Disease Forms or Types Just like in many health conditions, vWD is classified into different forms. Type 1 is the most prevalent and is the mildest form, where in vWF in the blood is decreased. The symptoms manifested are mild and may not even be detected. However, use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can aggravate the condition. People with Type 1 (partial quantitative deficiency), vWD do not have spontaneous bleeding but may bleed considerably with trauma, medical and dental procedures. In Type 2 (qualitative deficiency) vWD, there is an abnormality in vWF. This type is further subdivided into Type 2A and Type 2B. In Type 2A, the multimer which are the building blocks in VWF are smaller than the normal size and rupture easily. In Type 2B, vWF glues to the platelets too well resulting to the clustering of the platelets which can cause reduced platelet number. There are 2 more subtypes (2M and 2N) but these are much rarer. In Type 3 (total deficiency) vWD, there is severe bleeding with vWF and FVIII in the blood at very low levels. Pseudo or platelet type of vWD is comparable to Type 2B but in this case, t here is a deficiency in the platelets instead of vWF (Griffin 2010). Prevalence of vWD VWD is prevalent worldwide and can also manifest in animal classes including canine and hogs. Its occurrence in people differs depending on the method applied to identify medical findings. It has been reported in two extensive epidemiologic researches that symptoms and signs of vWd were evident in up to 1% of children and infant population (Werner, Broxson, Tucker, Giroux, Schults, and Abshire 1993). Type 3 vWD

Maritime Law in Relation to Time Charter Hire Essay

Maritime Law in Relation to Time Charter Hire - Essay Example This is followed by definition of maritime law and providing a brief explanation to help understand the concept at hand. After looking at maritime law, the context then analyzes the two statements, identifying the best statement that suites maritime law as far as Time Charter Hire is concerned. The statements are: â€Å"I have come to the conclusion that hire must be treated in the same way as freight, and that to do so is not an extension of the established exception. It is only in comparatively modern times that the word ‘hire’ has been used. It was formerly known as ‘time freight’ or ‘time-chartered freight’. Indeed, in marine insurance terminology, ‘freight’ still includes ‘hire’.†Ã‚  (The Satya Kamal [1975] 2 Lloyd's Rep 188, per Donaldson J.) â€Å"‘Freight' is payable for carrying a quantity of cargo from one place to another. 'Hire' is payable for the right to use a vessel for a specified period of time, irrespective of whether the charterer chooses to use it for carrying cargo or lays it up, out of use. Every time charter contains clauses which are quite inappropriate to a voyage charter, such as the off-hire clause and the withdrawal clause. So different are the two concepts that I do not think the law as to 'freight' can be applied indiscriminately to 'hire.' (Lord Denning MR in The Nanfri [1978] QB 927.) Relationship between Maritime Law and Time Charter Hire Maritime law is a body of laws, treaties and conventions that presides over international confidential business or other matters engrossing ships, shipping or offenses taking place on open water2. Laws between countries controlling things like national versus international waters are regarded as public international law and are well identified as the Law of the Seas. Through these waters is where the business of time charter hire occurs where an individual can hire a vessel and use to transport cargos from one specif ic port to another. Maritime law, which is also termed as admiralty law, is one of the most developed and oldest types of law. It covers all the laws that rules over contract, tort, ships, marine business, shipping, and employee recompense assertions that take place on the navigable waters of the world. The law is helpful in determining the amount of freight to be issued to the vessel owner when used by a voyage charterer. Subjects of maritime law can encompass towage, salvage, maritime liens, marinas, maritime contracts, and maritime damages. This means that both voyage charter and time charter are covered by these law thus, enhancing contracts made between charterers and owners. Despite the fact that the subjects under the umbrella of maritime laws are many, there are numerous of them that are pretty interesting. For instance, there are rules that preside over what takes place when an individual finds property that had lost. Under international rules, if possession is lost on the water and found by another individual, the finder can assert a salvage present for recovered possession. As a result, if a ship is destructed and loses cargo during an awful ocean storm, the retriever can ask the shipping company to disburse them money for any of the cargo they recover. Note that this takes place after the vessel owner and the charterer have settled the issue of freight or hire. Therefore, if the vessel gets involved in lose of possession, the owner is not involved at all. The case now remains between the charterer and the retriever. In most cases, the salvage