A stepfather or stepdad is a non-biological male parent married to ones preexisting parent. A stepfather-in-law is a stepfather of ones spouse. Children from his spouses previous unions are known as his stepchildren. Culture
Though less common in literature than stereotypical evil stepmothers, there are also cases of evil stepfathers, such as in the fairy tales The Gold-Bearded Man (in a plot usually featuring a cruel father) and The Little Bull-Calf. One type of such tale features a defeated villain who insists on marrying the heros mother and makes her help him trick the hero and so defeat him. Such tales include The Prince and the Princess in the Forest and The Blue Belt, although the tales of this type can also feature a different female relation, such as the stepsister in The Three Princes and their Beasts. In fiction, evil stepfathers include Claudius in Hamlet (though his role as uncle is more emphasized), Walter Parks Thatcher in Citizen Kane (though this is debatable), Murdstone in Charles Dickenss David Copperfield, the King from the movie Radio Flyer, and Gozaburo Kaiba (who adopted Seto and Mokuba Kaiba) from Yu-Gi-Oh!. The Stepfather  also depict an evil father who has murdered his family and subsequent families. The film Sucker Punch features a sexually abusive stepfather.In his opera La Cenerentola, Gioacchino Rossini inverted the tale of Cinderella to have her oppressed by her stepfather. His motive is made explicit, in that providing a dowry to Cenerentola would cut into what he can give to his own daughters.
Decreased respiratory effort: Central nervous system impairment leads to decreased respiratory effort. The respiratory center of the brain is located in the pons and medulla and is primarily driven by elevated carbon dioxide levels in the blood (hypercapnia) with decreased oxygen levels (hypoxemia) serving as a less potent stimulus. Central nervous system disorders, such as stroke and tumors, may cause hypoventilation. Drugs may decrease respiratory effort as well, such as opioids, sedative-hypnotics, and alcohol. These lower respiratory drive by blunting the response of the respiratory center of the brain to hypercapnia. Metabolic disorders could also decrease respiratory effort. Hypoglycemia and hypotension depress the central nervous system and compromise the respiratory system. Respiratory muscle weakness: Neuromuscular disorders may lead to respiratory muscle weakness, such as spinal cord injury, neuromuscular diseases, and neuromuscular blocking drugs. Respiratory muscle fatigue can also lead to respiratory muscle weakness if patients breathe over 70% of their maximum voluntary ventilation. Breathing over an extended period of time near maximum capacity can cause metabolic acidosis or hypoxemia, ultimately leading to respiratory muscle weakness. Diagnosis
Diagnosis requires clinical evaluation, as detailed below. Initial assessment
After determining the scene is safe, approach the patient and attempt to converse with him or her. If the patient responds verbally, you have established that there is at least a partially patent airway and that the patient is breathing (therefore not currently in respiratory arrest). If the patient is unresponsive, look for chest rise, which is an indicator of active breathing. A sternal rub is sometimes used to further assess for responsiveness.